ORAL ANSWERS TO QUESTIONS

INTERNATIONAL DEVELOPMENT

The Secretary of State was asked-

Yemen

Caroline Nokes: What recent assessment he has made of the developmental situation in Yemen; and if he will make a statement.

Graham Evans: What recent assessment he has made of the developmental situation in Yemen; and if he will make a statement.

Mark Spencer: What recent assessment he has made of the developmental situation in Yemen; and if he will make a statement.

Alan Duncan: Yemen is of the highest priority to the coalition Government. Subject to the Department for International Development's bilateral aid review and the security situation in Yemen, DFID is inclined to increase its commitment to that country. We believe strongly in the power of development to give solid foundations to a country that faces threats to its stability and economy.
	The UK is playing a leading role in the Friends of Yemen process, in which our partnership with Gulf states is an essential element. My right hon. Friend the Secretary of State recently visited Saudi Arabia and Kuwait to exchange views on Yemen and to build our common approach. That will help to ensure that the commitments made in New York in September are delivered in time for the next Friends of Yemen meeting in Riyadh in February.

Caroline Nokes: Given the difficult security situation in Yemen, will the Minister outline UK priorities in that country?

Alan Duncan: DFID's programme is part of the UK strategy to address instability and conflict in Yemen and to develop the economy. We engage with the Government and other donors to create the political will needed for action on reforms. Our work helps to make people's lives better by delivering basic services such as health, education and justice to the poorest communities, and to provide jobs and short-term employment through cash-for-work schemes. We also provide life-saving humanitarian support for the 300,000 displaced people in Yemen.

Graham Evans: At the last International Development questions, I raised the importance of Yemen in the war on terror, which the subsequent ink cartridge plot underlined. The Gulf states are obviously key to addressing Yemen's challenges. What are the Government doing to engage with those states?

Alan Duncan: The security situation is obviously of the utmost importance. The most important Gulf partner is the Kingdom of Saudi Arabia, which co-chairs the Friends of Yemen process, but more than $3 billion-worth of pledged financial support has remained unused since 2006. We are therefore pressing for better donor co-ordination, in which the Gulf states are obviously crucial partners.

Mark Spencer: I welcomed the Minister's speech at Chatham House-he set out the challenges facing Yemen and spoke of putting development and diplomacy at the heart of our response. Will he inform the House what progress has been made to implement reform through the Friends of Yemen process?

Alan Duncan: In my speech at Chatham House, I outlined the importance of development in Yemen. The Government want to underpin that country now rather than have to step in later should things get worse. Through the Friends of Yemen process, we are helping the Government of Yemen with the implementation of an International Monetary Fund financial reform programme. I stress very strongly that we are not telling Yemen what to do; we are working as a partner to support it in facing its challenges.

Keith Vaz: Mr Speaker, you very recently met the Speaker of the Yemeni Parliament, and President Obama and the Prime Minister spoke about Yemen last week at the G20. Processes are very welcome, as is Britain's leadership role in this whole endeavour, but we need positive action. Will the Minister ask the Foreign Secretary to issue an invitation to the Yemeni Foreign Minister and other Yemeni Ministers, so that they can come to London as a matter of urgency-before Christmas-and we can implement the very good words that the Minister has just spoken?

Alan Duncan: I am grateful to the right hon. Gentleman for his suggestion-he has a strong interest in, and knowledge of, Yemen. His suggestion is constructive. There will be a further Friends of Yemen meeting in Riyadh. If we are to get anything out of that meeting, we have got to get cracking now, which means that constant purposeful engagement with our Yemeni counterparts is essential. I will certainly ask the Foreign Secretary to take up his suggestion.

Harriet Harman: It is obviously important for us to do all we can to help to tackle poverty and instability in Yemen, but where there is instability, it is even more difficult to get aid to people who need it. The expertise of DFID officials in that regard is widely respected around the world. Will the Minister assure us that as the work of his Department is reviewed, nothing is done to undermine its ability to play its part in ensuring that aid in conflict zones really gets to those who need it?

Alan Duncan: May I say what a pleasure it is to be up against the right hon. and learned Lady once again, after a little gap? What she says is absolutely right. We are, as I said, inclined to increase our support for, and spend in, Yemen, but obviously the security situation will determine whether we can put enough boots on the ground to deliver the aid and assistance that we wish to deliver. Crucially, however, we are looking on our work there as a pioneering exercise in trying to address the challenges of a fragile state before its condition gets worse.

British Charities (Funding)

Daniel Poulter: What funding his Department provides to British charities with international developmental goals operating overseas.

Andrew Mitchell: In 2009-10, the Department for International Development provided £362 million to UK charities and civil society organisations to assist in poverty reduction overseas. The global poverty action fund, which will increasingly shape partnership with charities and non-governmental organisations, was launched on 27 October.

Daniel Poulter: I am sure that the Secretary of State would agree that we need to get funding to the right place. On improving women's health overseas, does he agree that the focus should be on making interventions in the right place, which is during delivery and childbirth, which account for over 50% of deaths among women? That is where we should be focusing our resources when we fund overseas aid.

Andrew Mitchell: My hon. Friend is absolutely right. Reproductive, maternal and newborn health care is the subject of a business plan discussion that is under way. With his expertise, I very much hope that he will contribute to our thinking on that. The plan will be published in January. As he said, we need to focus on the continuum of care, up to birth and beyond. We are quite clear about the importance of the issue, but he will know that placing women's choice over whether and when they have children is at the heart of all the overseas programmes that we run.

Rushanara Ali: Let me declare an interest in that I recently went to Bangladesh as a guest of Oxfam. I am sure that I join the whole House in paying tribute to the excellent work of British development non-governmental organisations around the world. In Bangladesh, I saw Oxfam's work in raising awareness of the impact of climate change on some of the world's poorest. Although the Government's commitment to continue the work on development and climate change is welcome, the commitment of the international community still falls short. Ahead of Cancun, what steps will the Government take to push for a greater commitment on climate finance from other countries?

Andrew Mitchell: I thank the hon. Lady for what she said about the quality of the programme and those who staff it in Bangladesh. I am glad that she was able to visit our programme last week. She has seen a country where climate change affects the everyday lives of millions of people, and she is quite right to underline the Government's commitment to ensuring new and additional mechanisms for raising international finance to tackle climate change. I will be making a speech on the subject tomorrow, and the Government will be pressing hard in the run-up to Cancun and beyond to see that we make significant progress in this area.

Gary Streeter: British development NGOs are world class and do a fantastic job, but has my right hon. Friend noticed that they all have their own advocacy departments and produce their own glossy publications? Would it not be better if they co-ordinated themselves slightly more, so as to cut out unnecessary duplication and competition?

Andrew Mitchell: My hon. Friend raises an important point. He will have noticed that the global poverty action fund that we launched is principally a matched fund, in order to enable the taxpayer to piggyback on the brilliant development outcomes that many of our NGOs produce. That is the right principle, whereby taxpayer support can focus on results, outputs and outcomes, and not on inputs.

HIV (Maternal Transmission)

Bill Esterson: What steps he is taking to eliminate mother-to-child transmission of HIV in developing countries by 2015.

Katy Clark: What steps his Department is taking to support the UNAIDS goal to eliminate mother-to-child transmission of HIV by 2015.

Stephen O'Brien: The Government are committed to a comprehensive approach to eliminating paediatric AIDS by focusing on where we have a comparative advantage-that is, on primary prevention of HIV among women of child-bearing age and on prevention of unintended pregnancies among women living with HIV through our investments in family planning.

Bill Esterson: Does the Minister agree that it is important that children who have already contracted HIV should be able to access medicines to stay alive? If so, will he join me in calling on pharmaceutical companies to make their patents available to the patent pool, so that there can be affordable HIV drugs for children?

Stephen O'Brien: I am grateful for the hon. Gentleman's question. The Government definitely support the UNITAID patent pool, which is, as he knows, a mechanism to facilitate the development of new, particularly fixed-dose combination drugs, partly to ward off the danger of monotherapies. That can be a key means of addressing the treatment challenge. We welcome UNITAID's decision to create a separate foundation to manage the pool's activities, and we recognise that that is an important step. We now need the milestones to be put in place as rapidly as possible, so that we can convert it to a working programme going forward.

Katy Clark: We believe that about 1.4 million pregnant women globally are infected with HIV, and about 1,000 babies are infected every day. We also believe that worldwide funding for HIV treatment is on the decline. Will the Government commit to making a strong contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and also to prioritising not just keeping those pregnant women alive, but taking steps to prevent those babies from being infected?

Stephen O'Brien: I am grateful to the hon. Lady for her question. I know from the number of her questions that I have answered that she takes a keen interest in these issues. The UK has been a good supporter of the global fund to date, and its replenishment is subject to current negotiations and the multilateral aid review.
	On the hon. Lady's particular concern, the reproductive, maternal and newborn health business plan is the coalition Government's key mechanism to prioritise the health of women and babies. It will support service delivery across the continuum of care needed to improve the health of women and girls, and will scale up the prevention of mother-to-child transmission-PMTCT-of HIV. That will address the underlying causes of the AIDS epidemic, gender inequality, gender-based violence and poverty. We will certainly-

Mr Speaker: Order. I am grateful, but the Minister must cut it short. Work needs to be done on these things. The answers are often far too long.

Andrew George: As the Minister said, the current Government strongly support, as did the previous Government, the Global Fund to Fight AIDS, Tuberculosis and Malaria. What is the Minister's assessment of the success of the country co-ordinating mechanisms, and particularly the efforts to ensure that co-infection of HIV and TB is well managed on a country basis?

Stephen O'Brien: The hon. Gentleman makes an informed point. One way of ensuring that the global fund, which scores well on its effectiveness, gets even better is to ensure that when there are conflicts in the country co-ordinating mechanisms, they are addressed. The co-infection of HIV and TB is an increasingly well understood area of research and practice, and that understanding is shaping the programmes through the multilateral aid review, and will therefore inform those programmes going forward.

Geoffrey Clifton-Brown: Will my hon. Friend tell the House what his Department is doing to support the Glion call to action, whereby consensus has been reached on the importance of family planning in preventing the spread of HIV, particularly maternal transmission from mother to child?

Stephen O'Brien: My hon. Friend makes the vital point that family planning is at the heart of ensuring that we prevent the transmission of these diseases. I assure him that we are putting women's and children's health at the core of our international development agenda, and will contribute to saving the lives of at least 50,000 women and 250,000 babies, and to providing 10 million more couples with access to family planning.

Access to Basic Sanitation

Fiona Bruce: What steps his Department is taking to reduce the number of people in developing countries without access to basic sanitation.

Andrew Mitchell: Reducing the number of people in developing countries without access to basic sanitation is a key priority of the coalition Government. The review of our aid programme will determine how we scale up our efforts and results in this area.

Fiona Bruce: I thank the Secretary of State for his reply. As Friday is world toilet day, what is his Department doing to raise the international agenda's priority to improve sanitation, particularly as 1.5 million children under five die every year from poor water hygiene and sanitation, which is more than die from malaria, AIDS and measles combined?

Andrew Mitchell: My hon. Friend is right to raise this issue in those terms. Diarrhoea is the biggest killer of children in Africa. This is a core subject for the coalition Government, and we are looking at it in our bilateral aid review. Although I do not wish to pre-empt that review, I can tell the House that I am confident that we will be able to ensure that, over the next four years, tens of millions of people will be able to gain access to clean water and sanitation who are currently unable to do so.

Barry Gardiner: I congratulate the Secretary of State on his remarks at the millennium development goals summit earlier this year, in which he emphasised the importance of sanitation, but will he explain to the House why, when the United Nations passed an historic resolution on 30 September affirming that access to water and sanitation were human rights and that Governments had a legal responsibility to deliver that access, the United Kingdom voted against it?

Andrew Mitchell: The hon. Gentleman needs to look carefully at the words that I used at the summit, about which he has just made his nice remarks. The fact is that 2.5 million deaths are caused by a lack of sanitation and 39% of people in our world do not have any access to a basic hygienic latrine. That is why we are focusing not on rhetoric but on results in trying to achieve specific outcomes in this very important area.

Malcolm Bruce: In the last Parliament, the Department for International Development acknowledged that it had refocused its priority on sanitation in the wake of the report by the International Development Committee. Given that, according to figures from the "Water, Sanitation and Health 2008" report, 79% of rural homes in India have no access to sanitation, what will the Secretary of State do within the programme for India to ensure that sanitation is a key priority?

Andrew Mitchell: The Chairman of the Select Committee is absolutely right to say that my predecessor admitted that the Government had taken their eye off the ball on this important matter. We are looking carefully at the Indian programme as part of the bilateral aid review and, as part of our examination of the programme, we will be looking specifically at our support for sanitation.

Mark Lazarowicz: The sanitation situation in Haiti remains critical after the earthquake in January this year. Following that earthquake, many of our constituents sent donations to support relief efforts there, and they are now very concerned about the outbreak of cholera, which is having a devastating impact. Will the Secretary of State update the House on the delivery of aid in Haiti, and on how the help is getting through to those who need it most?

Andrew Mitchell: The hon. Gentleman raises an extremely important subject. Britain has helped to bring clean water-the specific point that he raised, I think-to 380,000 people in Haiti. I sent a senior humanitarian expert last week to look at the situation on the ground, and to help specifically with co-ordination there. We are working with other United Nations agencies to ensure that this is prioritised and we are of course considering the recent appeal that the UN put out in that respect.

Global Fund Projects

Grahame Morris: What recent assessment he has made of the outcomes of projects under the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Andrew Mitchell: The global fund is assessed annually against key performance indicators. The programmes of the global fund have saved 5.7 million lives since 2000. The review of all our multilateral spending, including on the global fund, is designed to ensure maximum impact and value for money.

Grahame Morris: Does the Minister recognise that other countries look to the United Kingdom for leadership on HIV strategy? If so, does he agree that a strong UK contribution to the global fund will encourage other countries that have not yet made their financial contributions to step up to the plate?  [ Interruption. ]

Mr Speaker: Order. There are far too many private conversations taking place in the Chamber. That is very unfair to the hon. Gentleman and the Secretary of State and unimpressive to those following our proceedings. The Secretary of State is champing at the bit; let us hear him.

Andrew Mitchell: The hon. Gentleman is right to underline the importance and success of what the global fund has achieved. This includes circulating 2.8 million people with antiretrovirals, diagnosing and treating 7 million people with tuberculosis and distributing more than 122 million bed nets to help to prevent malaria. We have sent a clear signal to the global fund of strong support in this replenishment round. The precise level of that support will be dictated by the multilateral aid review.

Asbestos Products

Jim Sheridan: What steps his Department is taking to ensure that funds allocated for development programmes by his Department are not used to purchase imported asbestos products.

Alan Duncan: Asbestos is banned in 52 countries, including in the EU and the UK. We are totally opposed to its use anywhere, and would deplore its supply to developing countries. We are not aware that DFID funds have been spent on asbestos products, and we would take urgent action, should we be so advised.

Jim Sheridan: I thank the Minister for that response, but can he assure the House that UK assistance to improve health standards in developing countries is not compromised by asbestos mining in Quebec? He may be aware of the multimillion dollar guarantee for development in Quebec, which might mean millions of tonnes of asbestos being dumped on unsuspecting populations in the years to come, with more than 4,000 people killed a year.

Alan Duncan: I note that the hon. Gentleman has campaigned tirelessly on asbestos and pleural plaques, and I studied his debate on the subject in Westminster Hall last year. I understand that Canadian exportation of asbestos is a cause for concern, and I will pass the issue he raises to my colleagues in the Foreign Office and the Department for Business, Innovation and Skills. From my Department's point of view, we will take all necessary steps to ensure that we do not use dangerous asbestos products anywhere in the world.

Global Plan to Stop TB

Virendra Sharma: What assessment he has made of the likely effects on the incidence of tuberculosis in developing countries of the revised global plan to stop TB.

Stephen O'Brien: I know the hon. Gentleman takes a close interest in the terrible suffering caused by tuberculosis around the world. I am happy to confirm that the Government welcome the Stop TB Partnership's revised global plan, which sets out a clear road map to achieve ambitious targets, including to halve TB deaths by 2015. This will require making progress on the underlying causes.

Virendra Sharma: I thank the Minister for his response. As I am sure he knows, TB needlessly kills 1.7 million people a year, yet no new treatments or vaccines have been developed for 30 years. What are the Government doing to ensure that the UK plays its part in eradicating this disease by funding TB control measures and supporting the development of new drugs, diagnostics and vaccines?

Stephen O'Brien: The UK is committed to reducing unnecessary deaths and suffering from TB. My Department is currently reviewing its aid programme to determine how to achieve better value for money for the taxpayer and accelerate progress towards achieving all the millennium development goals. We will certainly review the forward approach to TB, including research, once we have the findings from the bilateral and multilateral aid reviews. As of 2009-10, we estimate that about £55 million was spent on direct programmes, and health system strengthening also needs to be taken into account.

Jim Shannon: Somalia is one of the countries with the highest incidence of TB. Will the Minister say how practical it is to reduce the incidence of TB across the world, particularly in countries where law and order has broken down?

Stephen O'Brien: The hon. Gentleman is quite right to identify the fact that TB ravages countries, not least in conflict states. As we design programmes that will have an effect in conflict states, it is vital that TB is right there among the very top of interventions. As we go through our bilateral aid review and focus on hard-to-reach people in conflict states such as Somalia, we must ensure that TB is one of the pre-eminent issues to be tackled.  [Interruption.]

Mr Speaker: Order. There is far too much noise, which is indisciplined and discourteous. I, for one, want to hear Mr David Ruffley.

G20 Summit (Seoul)

David Ruffley: What the development outcomes were of the G20 summit in Seoul; and if he will make a statement.

Andrew Mitchell: G20 leaders endorsed the Seoul development consensus on shared growth and agreed to a multi-year plan to tackle the obstacles to growth in poor countries. As part of this plan, leaders also agreed to take measures to increase trade within Africa.

David Ruffley: At the summit, the Government rightly stressed the need for a free trade area for Africa. At present, only 10% of trade in Africa is between African countries. Does the Secretary of State agree that knocking down the trade walls between African countries will deliver economic benefits far outstripping the amount of aid that developed countries can give?

Andrew Mitchell: My hon. Friend is absolutely right to make the point about the importance of having a pan-African free trade area-one of the four specific areas championed by the Prime Minister at the G20 summit in Seoul. Knocking down those trade walls, having one-stop border posts and promoting trade within Africa is the key area in helping people to lift themselves out of poverty throughout Africa.

Hugh Bayley: What meetings did the Prime Minister have with other G8 leaders in Seoul to persuade them to reinstate the commitments to increase aid, which they made at Gleneagles?

Andrew Mitchell: My right hon. Friend raised the matter not only in private but specifically at the table. He pointed out that it was hard to expect leaders in the developing world to stand by their commitments to their people if leaders in the G8 and others did not stand by the commitments that they had solemnly made at Gleneagles and beyond on the importance of increasing our support for the poorest in the world.

UN Relief and Works Agency

Jo Johnson: What recent assessment he has made of the value for money of his Department's aid delivered through the UN Relief and Works Agency.

Alan Duncan: UNRWA is performing well against agreed performance indicators and delivering value for money with United Kingdom funding. For instance, it is delivering teaching to nearly half a million children, and social services to more than a quarter of a million. During my recent visit to the Palestinian territories, I announced an extra £8 million to reward UNRWA's good performance and ease its budget shortfall.

Jo Johnson: During a recent visit to Gaza, it was obvious that UNRWA was struggling to obtain the construction materials that it needs to rebuild schools and find housing for refugees. Does the Minister agree that DFID would derive greater value for money if the partial blockade were completely lifted?

Alan Duncan: I entirely agree with my hon. Friend. I am glad that he was able to see the situation in Gaza for himself.
	Although some progress has been made since Israel eased access restrictions, UNRWA is still unable to import the volume of reconstruction materials that it needs. Any restricted access enhances the tunnel economy and risks putting revenue straight into the hands of Hamas, which in itself is entirely counter-productive.

PRIME MINISTER

The Prime Minister was asked-

Engagements

Mark Lancaster: If he will list his official engagements for Wednesday 17 November.

David Cameron: I am sure that the whole House will wish to join me in paying tribute to Ranger Aaron McCormick of 1st Battalion The Royal Irish Regiment, who died on Remembrance Sunday. His commanding officer has described him as
	"the epitome of the Irish Infantry soldier: tough; selfless; good-humoured and full of compassion."
	He showed astonishing bravery, leading the way in clearing improvised explosive devices for the safety of local civilians and his fellow soldiers. We send our sincere condolences to his family, friends and colleagues.
	I am sure that the whole House will also wish to join me in sending our warmest congratulations and best wishes to Prince William and Kate Middleton on their engagement. I am sure that everyone agrees that it is wonderful news. We look forward to the wedding itself with excitement and anticipation.
	This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today.

Mark Lancaster: I associate myself with the Prime Minister's comments.
	Possibly the best piece of news to emerge from the unemployment figures this morning is the rise in the employment count, but small businesses in Milton Keynes are still concerned about both the cost and the bureaucracy of taking on extra workers. What can the Government do to help them?

David Cameron: My hon. Friend has made an extremely good point. We must do more to make it easier for small businesses to take people on. However, this morning's figures are good news. The claimant count is down by 3,700 on the month, unemployment as defined by the International Labour Organisation is down by 9,000 on the quarter, and crucially, as my hon. Friend has said, employment is up by 167,000 on the quarter.
	We are helping small businesses by cutting the small business rate of corporation tax, we have the "one in, one out" rule so that new regulations will be limited, and we have a new enterprise capital fund to provide additional equity finance. We need to do all those things, but I think we also need to do more to help small businesses to take people off the unemployment register and put them back into work.

Harriet Harman: I join the Prime Minister in paying tribute to ranger Aaron McCormick of 1st Battalion The Royal Irish Regiment, who died on Sunday. His brave service in our armed forces will be remembered, and we send our deepest condolences to his family.
	I also join the Prime Minister in sending our warmest congratulations to Prince William and Kate Middleton on their engagement.
	Will the Prime Minister tell the House how many fewer police officers there will be as a result of his 20% real-terms cut in the police budget?

David Cameron: It will be up to individual police forces-[Hon. Members: "Ah."] This is very important. It will be up to individual police forces to try to ensure that they maximise resources in the front line. What we said in the spending review was that it was possible to retain the high level of visibility and activity of police on our streets. That is the challenge to every police force in the country, and I think that when we look across police forces and see how many officers there are in human resources and information technology and performing back-office functions, it is clear that we can succeed.

Harriet Harman: Her Majesty's inspectorate of constabulary says that while there are, of course, efficiencies, cuts of beyond 12% will inevitably result in cuts in the number of front-line police officers, yet the Prime Minister is asking not for 12%, but for 20% cuts. As usual, he has ducked the question, and he will not admit how many front-line police he is cutting. He used to be very clear about protecting front-line services. This is what he said on 2 May:
	"any cabinet minister if I win the election...who comes to me and says, 'Here are my plans' and they involve frontline reductions, they'll be sent straight back to their department to go away and think again."
	So what did he say to the Home Secretary?

David Cameron: This is question has been asked of the right hon. and learned Lady's own former Home Secretary-now the shadow Chancellor-and this is what he said. [Hon. Members: "Answer."] He was asked- [Interruption.]

Mr Speaker: Order. The Prime Minister's answers will be heard.  [Interruption.] Order. What Opposition Members make of them is up to them, but they will hear them.

David Cameron: Thank you, Mr Speaker. Andrew Neil asked the shadow Chancellor a very simple question:
	"Can you guarantee if you form the next Government that police numbers won't fall?
	Alan Johnson: No."
	That is what Labour said. It can engage- [Interruption.] If the right hon. and learned Lady wants to, why do we not engage in a proper debate about how we try to make sure we maximise resources on the front line? That is what we are asking the police force to do, and that is what the Opposition should be involved in, instead of this cheap game.

Harriet Harman: We were absolutely clear in our manifesto, and the former Home Secretary was absolutely clear, that we would guarantee central Government funding to protect front-line services. No wonder the Prime Minister's Back Benchers are so silent: he is planning to cut their police forces by 20%.  [Interruption.] Their constituents will be astonished to see them cheering 20% cuts in the police budget.
	The Prime Minister will be aware of the report of the chief constable of Greater Manchester setting out how front-line police numbers will have to be cut. What does the Prime Minister say to the people of Greater Manchester, who will be deeply worried about the cut in police numbers?

David Cameron: First, let me answer the point the right hon. and learned Lady made about what Labour said after the election. The shadow Chancellor was asked about- [Interruption.] Well, the right hon. and learned Lady raised the point about what was said after the election, and the Shadow Chancellor said:
	"If Labour had won the general election, the Home Office budget would have been cut and the police would have had to make savings."
	That is what it said.
	The right hon. and learned Lady asks about Greater Manchester, so let me answer specifically about Greater Manchester. First, the chief constable of Greater Manchester has said that his plans are putting "the maximum resources" on front-line policing, and I am not surprised he is able to say that, because here are the figures for the employment levels in the back-office functions: human resources, 187 people for that force; fleet vehicle maintenance, 106 people; finance, 106; IT- [Interruption.] Well, Opposition Members want to know the facts about Greater Manchester police, and these are the facts about Greater Manchester police. Guess how many people are involved in IT in Greater Manchester police: 225. This is the debate we ought to be having: how do we get resources from the back office on to the front line? How do we do it when right now only 11% of police officers are on the streets at any one time? That is the mess we have inherited; that is the mess we are going to clear up.

Harriet Harman: But the chief constable's report is clear. As well as cutting important back-office staff, front-line police will have to be cut; that is what the report says. The Prime Minister says-he always says this-that all this is unavoidable because of deficit reduction. In that case, can he explain why he is spending what the Association of Police Authorities says is £100 million creating new elected police commissioners at the same time as cutting police numbers?

David Cameron: The police commissioners will replace the police authorities-that is the point. The key issue, which the right hon. and learned Lady has now addressed, is that we are doing this because we inherited the biggest budget deficit in the G20. It is no good Labour talking about cuts, because it was planning 20% cuts. We are just having to introduce measures to deal with the mess that Labour made, but instead of just top-down cuts, we want to work with these organisations and say, "How do we help you to maximise the impact on the front line?" That is why we are scrapping the stop form-Labour introduced that- and that will save 450,000 hours of police time. We are going to limit stop-and-search reporting, and that will save another 350,000 hours of police time. This is the nonsense, the bureaucracy and the form-filling that Labour put in place. We are freeing the police officers to get out to do the job that people want them to do.

Harriet Harman: By the way, it is an extra £100 million and the Prime Minister is spending it on elected police commissioners when that extra £100 million is the equivalent of hundreds of police officers. Police numbers do matter in tackling crime-of course they do. Will he drop his proposal for elected police commissioners and give the police the resources they need to protect front-line policing?

David Cameron: The straight answer to that is no, I will not, and I will tell you why. It is about time we had more accountable police forces in our country. I want there to be police commissioners so that when they do a good job calling the police to account and they are fighting crime in the way that local people want, they get re-elected. If they do a bad job, they will get thrown out. We all think that democracy is a great thing in here; what about a bit of democracy in policing as well?

Harriet Harman: What local people want is to see their local police on their local streets. There he is posing as the guardian of probity in public finances. It cannot be denied that he knows a thing or two about posing. Why, at the same time as he is cutting police numbers, did he choose to use public money on not only a vanity photographer, but on putting staff from Tory headquarters on to the public payroll, with taxpayers footing the bill. Why did he do that?

David Cameron: Even the jokes are lame this week.
	Let me tell you a few people we will not be employing. We will not have special advisers ordering around civil servants like Labour did. We will not be employing Damian McBride to smear the wives and families of politicians. We will not be employing Alastair Campbell to sex up dossiers to make the case for war. I have got a list-[Hon. Members: "More, more."] Do you want some more? There is plenty more. I have got a whole list of people here who were employed by the last Government. Here is one, Ruth Mackenzie. She was a Labour party employee. She then became an expert adviser in the Department. What was her qualification? Well, according to  The Guardian, "She speaks new Labour". Well, there we are, that is a great qualification. There is another one here-

Mr Speaker: Order. I think I got the gist of it. We do not need to hear any more. Let me just say to the House, and that includes every Member of the House, that it is now time that we got back to questions and answers about the policies of the Government. That is what the public expect and that is what the public are entitled to get.

Brian Binley: More than 41% of all loans drawn from the enterprise finance guarantee scheme were issued by the Royal Bank of Scotland and a further 30% were issued by Lloyds bank, yet 27 banks are operating in the marketplace. No matter how we look at the figures, that means that 25 banks are simply not doing their job and supporting small and medium-sized enterprises. What will the Prime Minister do to ensure that those dilatory banks do all they can to help SMEs have the working capital-

Mr Speaker: Order.

Brian Binley: To ensure-

Mr Speaker: Order. The hon. Gentleman will resume his seat not when he chooses, but when I choose.

David Cameron: My hon. Friend has spoken up very passionately-and rightly-about that issue, because one of the keys to securing recovery is to get bank lending going. His points are extremely valid. A bank-led £1.5 billion business growth fund is providing finance to SMEs and we have added to that with the enterprise capital funds programme and the enterprise finance guarantee. That should secure an extra £2 billion of lending, but I agree with him that we need to be vigilant on the issue and to keep pressurising the banks to do more to help those small businesses.

Gemma Doyle: Reports suggest that as many as 1,700 of my constituents will lose their jobs as a direct consequence of the Government's spending cuts. What action will the Prime Minister take to ensure that unemployment in West Dunbartonshire does not reach the levels that it did under the last Tory Government?

David Cameron: What we have to do-the hon. Lady is right-is make sure that there is a private sector-led recovery. That is why we have low interest rates, corporation tax coming down, cuts in national insurance for new firms that are hiring people and less regulation. We have all those advantages as an economy and we need to engineer a private sector-led recovery. The unemployment figures today, which I notice that the right hon. and learned Member for Camberwell and Peckham (Ms Harman) did not go anywhere near, are a good sign that that private sector-led recovery is under way.

Priti Patel: In September, Ofsted raided Powers Hall Infant School in Witham, despite an outstanding head teacher making a formal complaint about the inspector and the poorly constructed report by Ofsted. Two teachers have resigned from the school and the head teacher is now asking for the school to be re-inspected. Will the Prime Minister visit that tremendous school to hear at first hand the disgraceful and bureaucratic way in which it has been treated by Ofsted? Will he press for Ofsted to withdraw this flawed report while an independent inquiry is launched?

David Cameron: My hon. Friend speaks up powerfully for her constituency. I can understand the concern. Obviously, it is important that school inspections are carried out to the highest possible standards and I do not think that it would be right for me to comment in detail on an individual case. There would be dangers in automatically withdrawing a report because a complaint has been made-some might use that to frustrate the process-but we need to ensure that reports are done in a good and professional manner.

Constituency Visit (Central Ayrshire)

Brian H Donohoe: When he next expects to visit Central Ayrshire.

David Cameron: I look forward to visiting Scotland soon.

Brian H Donohoe: I note that the Prime Minister did not say that he was coming to Central Ayrshire; he does not know what he is missing. If Mohammed will not come to Ayrshire, is it possible, given the reports in the national press about Irvine, the largest town in my constituency, having the highest unemployment in Scotland, that he would meet a small delegation to discuss the question of unemployment?

David Cameron: The hon. Gentleman raises what will be one of the defining issues of the next few years, which is how we get people out of unemployment and how we ensure that losses of jobs in the public sector are made up for by growth in the private sector. That is an absolutely key area. That is why bank lending matters, why helping SMEs matters, why tax rates matter and why the regional growth fund that we are introducing helps. I am certainly happy to meet the hon. Gentleman-I wanted to keep him in a bit of suspense-just in case I do not make it to Central Ayrshire.

Several hon. Members: rose -

Mr Speaker: Order. As the House will know, that was a closed question about Central Ayrshire. We are now back to open questions.

Engagements

Stephen Gilbert: The Prime Minister will no doubt be aware that my constituency has suffered from severe flooding overnight. Many hundreds of people are affected and there has been significant damage and disruption in central Cornwall. Will he join me in commending the professionalism of the emergency services and their response to the incident and will he further commit the Government to doing all they can to help support the affected communities in the coming weeks and months?

David Cameron: I can certainly do that. I have just spoken to Alec Robertson, the leader of Cornwall council, about the situation in Cornwall. There was a very difficult night in central and south-east Cornwall. The emergency services-the police, the coastguard, the fire services and search and rescue-have been working around the clock and they have done a fantastic job, and I am happy to send that message loud and clear from this House. There are no reports of casualties yet, but there have been some medical evacuations. The train line is still blocked and the A38 is still closed, but I know that everyone is working around the clock to try to get this sorted. We have said that we stand ready to help in any way we can and what the hon. Gentleman says is important-we have to remember that when the flood waters start to recede, many of the biggest problems arise with insurance and getting people back into their homes. We must ensure that we help people in every way we can.

Owen Smith: Writing in  The Sun in January this year, the Prime Minister said that
	"midwives are stretched to breaking point...So we will increase the number of midwives by 3,000...This is the maternity care parents want...And under a Conservative Government, it is what they'll get."
	This morning, the Prime Minister stands accused by the Royal College of Midwives of reneging on that promise. Does he want to take this opportunity to differentiate himself from his Deputy's attitude to such solemn promises, and honour that pledge to midwives and mothers?

David Cameron: We do want to see an increase in the number of midwives and, unlike Labour, we are actually funding the health service in a way that makes that possible. The hon. Gentleman's shadow Chancellor said, when asked about our pledge to increase funding in the health service:
	"There is no logic, sense or rationality to it at all."
	I know the hon. Gentleman used to work on the "Today" programme, so let me give him a thought for the day: "The health service is better off with our Government".

Gordon Henderson: Will my right hon. Friend the Prime Minister take this opportunity to assure my constituents in Sittingbourne and Sheppey that planning circular 01/06 will be scrapped in the near future, and that Travelling communities will then be treated in the same way as settled communities with regard to planning law?

David Cameron: I am not fully up to date with that particular planning circular, but I reassure my hon. Friend that, as I have said here before, Traveller communities should be treated in a similar way to other communities, in that they cannot have planning permission retrospectively granted when they have not obeyed the rules. That is not right. Everyone should obey the law.

Bill Esterson: I wrote to the Prime Minister about my constituent, Scott Sheard from Formby. Scott suffered severe brain damage when he was assaulted in July, and he needs a wheelchair so that he can go home. Will the Prime Minister join me in welcoming the good news that Scott's wheelchair will be ready next week, and will he intervene to help others in Merseyside and elsewhere who have been on the waiting list for wheelchairs for far too long?

David Cameron: Yes, I am certainly happy to do that. The hon. Gentleman makes an extremely important point. MPs of all parties in all parts of the House, and anyone who has ever tried to get a wheelchair for anybody, will know that the delays and the lack of choice and the lack of power people have is incredibly frustrating. It must be possible in this day and age to put more power in the hands of patients or parents to make sure we have better choice, faster wheelchairs- [ Interruption. ] Sorry. We should get the wheelchairs a bit faster.

Andrew Griffiths: With Ministers taking 5% pay cuts and Departments facing a reduction of 19%, does the Prime Minister share my dismay that the Labour party is to receive an extra £1 million of taxpayers' money-an increase of 20%? If we are all in it together, should it not pay it back?

David Cameron: My hon. Friend makes a very good point. A lot of people on the Opposition Front Bench do not seem to understand that the taxpayer provides Short money and the amount that goes to Labour is going up by 21%. As other Departments are having to take such severe cuts-the cut in No. 10 Downing street, for instance, is 25%-I look forward to an offer from the Labour party.

Stephen Timms: I welcome the commitment the Prime Minister made two weeks ago to a new silicon valley in east London, but will it be like the promise to the midwives? Can he tell us how many jobs he wants to see created in east London, and what specific steps he and the Government will be taking to make that happen?

David Cameron: First, I praise the people who put together the idea of "tech city" in east London, in terms of the number of businesses they have actually encouraged to commit to going there-Google, Intel and others. I do not think it is right for the Government to try to identify the precise number of jobs that will be created, but we have seen a huge level of enthusiasm, great commitment from Ministers, and a number of businesses committing to going to Shoreditch and the Olympic park, where there is a fantastic space for an incubator for new businesses. I hope the right hon. Gentleman will help us to get behind that and create what could be a silicon valley for the east end.

Karen Bradley: One of the keys to securing economic growth in areas such as Staffordshire Moorlands is the promotion of vocational education and apprenticeships. Can the Prime Minister assure students and staff at further education colleges, such as Leek college in my constituency, of the Government's continued commitment to this area?

David Cameron: Yes, absolutely. My right hon. Friend the Skills Secretary produced the skills strategy yesterday, and yes, we are having to make difficult decisions, but in the middle of that, we are increasing the number of apprenticeships by 75,000 over what was planned, as well as putting more money into building FE colleges, which is vital for the future skills of our country.

Nigel Dodds: I endorse the sentiments expressed earlier by the Prime Minister in relation to the tragic death of Ranger Aaron McCormick of the 1st Battalion The Royal Irish Regiment, who was tragically killed on Remembrance day. His service and that of others will never be forgotten. Many troops from Northern Ireland are serving in Afghanistan.
	May I associate my right hon. and hon. Friends with the Prime Minister's expression of best wishes to the happy couple-the royal couple? We wish them well for the future and I hope they will enjoy a visit to Northern Ireland in due course.
	On Afghanistan, can the Prime Minister give us an update on the training and equipping of Afghan security forces, a process allowed only by the service and sacrifice of our troops?

David Cameron: The right hon. Gentleman is right. The training mission and the equipping and training of Afghan soldiers and police officers is not only essential for the future of Afghanistan, but is the way in which we will be able, over time, to draw our own soldiers down and bring them home. We have the NATO summit this weekend. That will be one of the most important issues on the agenda. The training mission is now being well supported. We are giving huge support, but other countries are coming in behind us. The performance of the Afghan army is improving, but we have to keep working at that and making sure that it has all the equipment that it needs.

Richard Harrington: Last week Warner Bros announced £100 million investment in Leavesden Studios in my constituency. That is very welcome, as it will provide more than 600 jobs and a real boost to the local economy. Will my right hon. Friend confirm that the producer tax credit for the film industry, which was significant in Warner Bros' decision to make the investment, will continue, and that the Government will consider ways to get British investors to invest in British films made here so that the profits remain in this country?

David Cameron: My hon. Friend makes an extremely good point. What Warner Bros is doing is very welcome. We are committed to supporting the film industry. We are committed to continuing with the tax credits that he speaks about. One of the keys to Warner's success in his constituency is the Harry Potter film franchise that it has been making. It has been incredibly successful. There is a great tip and key to filmmakers, which is that we must make films that people want to watch, and films that will have a benefit beyond themselves-that also encourage people to come and visit our country.

Tony Lloyd: Can the Prime Minister be very precise and tell the House whether he is honestly saying that if one in four police officers are taken out of Greater Manchester, as well as one in four of the police community support officers, that will have no impact on deterring and detecting crime? If he will say that, will he come to Manchester and explain it to people whose fear of crime is still a major issue?

David Cameron: What I say to the hon. Gentleman is, first, that the chief constable has said:
	"We have been working for some time on plans to ensure the Force provides the most efficient service and the maximum resources are focused on frontline policing."
	When one looks at the figures for how few police officers really spend their time on the beat because of the paperwork and the form-filling, and when one looks at how we are managing our police forces and at the numbers in human resources, finance, IT and training, I say that we must do better. There is a choice. We can either say, "All reductions in public spending are a disaster and we can't deal with them," or we have to try and find a way to get more for less. That is what we are doing in the coalition Government. The Opposition are just not engaged in the debate.

Malcolm Bruce: Does the Prime Minister agree that as an international trading nation and a leader in international development, it is vital that we can attract key people from around the world to this country for short and long-term stays? When will he be able to tell the House how the Government are finalising the criteria for the visa and immigration cap, to end the uncertainty that could damage investment in the UK as a preferred location?

David Cameron: I can tell my right hon. Friend that we are working on the issue. I do not think there will be any difficulties in achieving the two goals that we have. One is to get the immigration system that we inherited under control. The current level of net immigration into the UK of 200,000 a year-2 million over a decade-is too high. It needs to be brought down, but we should do that in a way that is business-friendly and helpful to the economy. When we look at the rules that we inherited and the fact that people were coming into this country under tier 1, but often had no skills at all or were not working in skilled jobs-some were even working in pizza restaurants-it is clear that the system was not working properly. That is what we have to get right.

Karl Turner: What does the Prime Minister have to say to my constituents on the Ings estate on Preston road in east Hull, who will now be left in unfit housing because his Government have scrapped the flagship housing market renewal programme, the Gateway pathfinder scheme? Over the past few days, I have been inundated with constituents who are desperate, living in properties surrounded by properties that are boarded up. I am seeing them tomorrow night at a residents meeting-what message of hope can I give them?

David Cameron: There are schemes like the regional growth fund that people in the hon. Gentleman's constituency will be able to apply for to help to deal with issues such as improving the level of housing. That is one of the schemes that we have. We also have a huge programme for upgrading and building new homes through the new rent scheme. All these can make a difference, and he can talk to his constituents about them.

James Morris: Sandwell metropolitan borough, part of which I represent, has very high levels of deprivation. Can the Prime Minister reassure the children and parents from schools in Sandwell that the Government, particularly with their pupil premium policy, are on the side of children and families in Sandwell?

David Cameron: I absolutely can do that, because we made some difficult choices in the spending review to say that we are going to put more money into early-years education for two-year-olds from deprived families. That was previously not available. We are going to fund extra hours for three and four-year-olds in nursery education. We are going to make sure that there is a pupil premium, never dreamed of by a Labour Government in 13 years in office, that is over and above the per-pupil funding in our schools. Then we are going to carry that through to university so that children on free school meals will get some time at university for free and will not have to pay the student premiums. All those things will make a big difference, and they show that this is a Government who have made some progressive choices in education, even though we inherited a mess that we had to clear up.

Bridget Phillipson: Does the Prime Minister agree with his Business Secretary that the scrapping of regional development agencies has been "Maoist and chaotic"?

David Cameron: Given that my right hon. Friend is implementing the policy, that is not his view. We all take the view that the RDAs wasted a vast amount of money. Many of them were not popular with the businesses in their area, and the local enterprise partnerships will do a much better job. I suggest to the hon. Lady that instead of complaining about it, she works with her local authorities to get a good local enterprise partnership in her area to start backing business, jobs and economic revival.

Amber Rudd: On a day when employment is at the top of people's minds, could I ask the Prime Minister to join me in congratulating the Saga Group on its wise decision to move into Hastings, which has very high public sector employment, with up to 800 new jobs for the town?

David Cameron: I am very happy to join my hon. Friend in congratulating Saga and the very good work that it does. I am sure that in choosing Hastings it has made an excellent decision. There is good news in today's unemployment figures, and we should celebrate that. There is a lot more to do to get this economic recovery under way, but it would help if we did not have so many people determined to talk down the performance of the British economy.

Ben Bradshaw: Does not the devastation in Cornwall illustrate the false economy of the Prime Minister's recent decision to slash investment in flood defences?

David Cameron: That is simply not the case. The fact is that the Department for Environment, Food and Rural Affairs will be spending over £2.1 billion on flood and coastal erosion risk management over the next four years; that is roughly the same as what was spent over the past four years. We made some difficult choices in the spending round, but we protected flood defences because that is important. But all the while we had to bear in mind the absolutely wretched and rotten inheritance we had from the lot over there.

Mr Speaker: We now have an Urgent Question. I call Mr Peter Bone.  [ Interruption. ] Before the hon. Member for Wellingborough gives the House the benefit of his thoughts, can I appeal to right hon. and hon. Members who are leaving the Chamber to do so quickly and quietly? Mr Bone wishes to be heard, I wish to hear him, and I hope that the House wishes to hear him.

Finance Ministers' Meeting (Ireland)

Peter Bone: (Urgent Question): To ask the Chancellor of the Exchequer whether he will make a statement on the Government's position about the proposed financial rescue package for Ireland.

Mark Hoban: I am grateful for this opportunity to make a statement to the House about Ireland.
	The House will understand that the Chancellor is currently in Brussels at the meeting of the Council of EU Finance Ministers. I understand that hon. Members are concerned about the events that have unfolded.
	Ireland has been facing difficult economic and banking challenges for some time, and as a member of the euro area its ability to use policy to respond to economic shocks is less flexible than our own. As a result, there are ongoing market concerns about Ireland's economic and financial resilience.
	Let us be clear: there has been no formal request for assistance from Ireland, or for that matter from any other member state. I hope the House will understand that it would be inappropriate for me to engage in any speculation on what might happen in Ireland, given that it has made no request for assistance. It is not for me to say whether Ireland should request assistance, just as I would not tell it how to run any part of its economy. Its large financial institutions have obviously got themselves into difficultly, and we very much hope it will be able to resolve those pressures.
	Ireland is one of our biggest export markets. We have very close economic ties with it and, as the Chancellor said this morning, it is in Britain's national interest that the Irish economy is successful, so we stand ready to support Ireland in the steps that it needs to take to bring about stability. I am sure that our fellow EU member states will share that sentiment, and I assure the House that we will keep it informed of developments.

Peter Bone: I thank the Minister for his response. At a time when the United Kingdom is already contributing extra funds to the European Union-over the next five years our net contribution will be £41 billion, an increase of more than £21 billion compared with the past five years-and when we are making drastic cuts in the UK's economy, does he think it is acceptable that any further funds should be committed to the EU?
	The coalition Government have made it clear that we will not join the euro during this Parliament, arguing that the euro, with its single interest rate but diverse economies, cannot work. Will the Minister confirm that we will not be joining the euro?
	The Government have also made it clear that the UK will not support the euro. Will the Minister therefore rule out the UK participating in any bail-out of the Irish economy? Will he also confirm that the €440 billion special-purpose vehicle facility-a voluntary intergovernmental agreement between eurozone countries -should be used for any such bail-out?
	Does the Minister further agree that the use of the stabilisation mechanism, which the United Kingdom guarantees up to £8 billion, was not intended to be used to bail out eurozone countries facing financial pressure? Finally, does he agree that what is required from the EU is support for member states' policies when, like Ireland, they are trying to do the right thing? Instead, the EU has undermined Ireland and created a crisis.

Mark Hoban: May I first reassure my hon. Friend that it is not the Government's intention to join the euro during this Parliament? I am not entirely sure what the Opposition's view is, but we have ruled that out.
	My hon. Friend mentions the two mechanisms that are available for stabilisation. The stabilisation facility is purely for eurozone member states, outside the auspices of the current treaties and a bilateral, Government-to-Government arrangement. The mechanism that he refers to is available to all members of the European Union. The previous Government and the previous Chancellor decided to join it in the days prior to the formation of the current Government, and I believe that they need to be held to account for that decision.

Christopher Leslie: Clearly, these are difficult times for the world economy, and Ireland is the current focal point of market concerns. Although the Minister offered little in the way of detail today, is it not clear that, stepping back, the overall long-term lesson to learn from these developments is that economic growth matters?
	Ireland is a vital trading partner, to which 7% of our exports are sold, and the current situation matters because its economic strength has a significant effect on our own growth prospects. Will the Minister accept that the emerging global recovery is fragile, and that to rely as heavily as the Government do on export-led growth in the years ahead is a risky gamble?
	Will the Minister confirm that this issue extends beyond trade, and that UK banks have lent about £83 billion directly to Irish households and companies? We saw at the G20 last week that the Government need to show stronger leadership on economic growth here and abroad, so can he reassure the House that any forthcoming package from the EU will address fundamental and underlying economic issues rather than act as a sticking plaster, merely tackling symptoms that may recur again and again in future?
	The previous Government were clear that the problems facing countries adopting the euro would need to be solved first and foremost by member states within the euro area. Will the Minister confirm that the principal fund designed for any loan to support the Irish or other eurozone countries would be the European financial stability facility, which is envisaged at about €750 billion? Are reports in today's  Financial Times correct that the UK is spending time and effort spinning any future action as "bilateral support" rather than co-ordinating with the EU? Would it not be better if the Government were straight with the public about what they plan?
	Does the Minister accept that, although we were right to stay out of the euro, it is essential that the euro is stable and successful for the long term? Will the Minister say categorically that the Treasury's position will be driven by the best interests of British growth and jobs and not designed to pander to the Eurosceptic political instincts of those in his party who might circle the eurozone in its time of difficulty?
	In 2006, the Chancellor wrote in  The Times that Ireland's economy provided a "shining example" to us all. Is it not clear now that, rather than being an example, it provides a warning of the dangers of a one-track economic strategy, built around austerity alone, that endangers growth and puts jobs at risk? Both abroad and at home, what matters is a strong strategy to rebuild jobs and growth.

Mark Hoban: The Chancellor made it clear this morning that we will do what we need to do in accordance with Britain's national interest. Ireland is our closest neighbour, and it is in our interests to ensure that the Irish economy is successful and that it has a stable banking system. He said that we stand ready
	"to support Ireland in the steps it needs to take"
	to bring about that stability. The reality is that Ireland has got some things right. It has a flexible labour market and low taxes. None the less, it made the same mistake as the previous Government-it failed to regulate its banks properly. The problem in Ireland is driven not by high public spending but by a banking crisis. If we listened to the Opposition, the UK would be the only country that was weakening rather than strengthening its fiscal position.
	It is clear that the actions we have taken have been welcomed by a range of bodies at home and abroad. What is happening at the moment demonstrates that concerns about sovereign debt issues have not disappeared. We should be grateful that, thanks to the actions of this Government, Britain has moved out of the fiscal danger zone.

Several hon. Members: rose -

Mr Speaker: Order. There is much interest and little time, so in questions and answers alike I require brevity.

William Cash: The €440 billion eurozone facility can be used without infringing either UK liability or sovereignty. The Darling guarantee mechanism with qualified majority voting involves, unnecessarily, both UK liability and sovereignty. Where it is in our national interest and we can afford it, why not provide a UK-Irish but non-EU loan?

Mark Hoban: I hear my hon. Friend's words, but reiterate to him and to the rest of the House that no request has been made for assistance, and that it would be inappropriate to make any further comments.

Kelvin Hopkins: I have a large number of Irish constituents, and I am naturally concerned about their families and livelihoods back in Ireland. The fact is that the Irish crisis is part of a wider crisis in the eurozone, affecting a number of countries that will be unable to sustain long-term membership of the euro. Is it not time to have discussions-privately, perhaps-about the possibility of reconstructing national currencies, particularly the punt, so that the Irish can join the sterling zone, where they belong, and not the eurozone?

Mark Hoban: I am sure that the Irish Government will have heard the hon. Gentleman's remarks. It is not for this Government to dictate policy to other EU member states.

John Redwood: As the Irish Government need a workout and not a bail-out to deal with their risks and credit problems, should not the British Government support them and resisting the foolish intervention by Germany, which is trying to use this as part of a power grab for the EU?

Mark Hoban: Let me repeat the remarks that my right hon. Friend the Chancellor of the Exchequer made earlier today. To an extent, they reflect the concerns raised by my right hon. Friend. He said:
	"Britain stands ready to support Ireland in the steps it needs to take."

Mark Durkan: Given that Chancellor Merkel's comments have caused such turbulence in the bond market in the past week, I welcome the measured and respectful terms in which the Financial Secretary and the Government have addressed the crisis in Ireland. Does the Financial Secretary accept the judgment of EU Commissioner Olli Rehn? He said:
	"In the case of Ireland in particular, we need to recall that sovereign debt has not been at the origin of the crisis. Rather, private debt has become public debt. The financial sector has misallocated resources in the economy and then stopped working. It needs reform."
	The problem does not apply only in Ireland. I remind the Financial Secretary that, if the national pension reserve fund is counted, Ireland's debt to GDP ratio is not that far wide of the UK's currently.

Mark Hoban: The hon. Gentleman makes an important point. The crisis is around the banking system in Ireland-it is not a fiscal crisis. Of course, we almost had to learn the lessons of failure to regulate the banking system. The Government therefore introduced radical reforms to strengthen the stability of the banking sector in the UK.

Duncan Hames: Does the Financial Secretary accept that it would be a disservice to families and businesses in Ireland to exaggerate their economic woes, just as it would be in this country?

Mark Hoban: We are in difficult times and it is best to focus on what can be done to help the Irish economy rather than engage in a debate about statistics on Ireland's current economic performance.

Denis MacShane: May I welcome the statement of the Financial Secretary and the Chancellor, and their offer of £6 billion of UK taxpayers' money to help stabilise the eurozone? We must all welcome the contribution to consolidating the eurozone as a sound economic area. However, what has happened to moral hazard? Most of the money will go to the banks. When will they pay anything-any price-for the crisis they caused?

Mark Hoban: I want just to reiterate-to correct the right hon. Gentleman-that no formal request has been received from the Irish for assistance.

Michael Fallon: Irrespective of our obligations under the new European mechanism, which the Labour Chancellor agreed, will my hon. Friend confirm that there is a strong British national interest in securing a stable banking system on both sides of the Irish sea?

Mark Hoban: My hon. Friend is absolutely right. We have strong economic ties with Ireland, which is one of our biggest trading partners. Our economies are closely interlinked, and it is therefore in our national interest to ensure that the Irish economy and banking system are stable.

Gisela Stuart: What is Her Majesty's Government's strategic view of the crisis? Should we bail out the Government or their banks?

Mark Hoban: I reiterate that no request for assistance has been received from the Irish Government.

Philip Hollobone: Will my hon. Friend confirm the extent of Britain's liability under the non-eurozone mechanism? Has he considered the possibility of renegotiating the package that the previous Government left us?

Mark Hoban: My hon. Friend should be aware that under the mechanism there will be no liabilities if no request for assistance has been made.

Michael Connarty: Does not the Financial Secretary think it worrying that, when the Irish Government consistently say that they do not require a bail-out, the speculators in the bond market-the hyenas who used to attack our currency-try to bring down the Irish Government's financial position? Is not it right to support Ireland and the euro, of which it is part?

Mark Hoban: As I said before, it is important that Britain stands ready to support the Irish Government to resolve those problems.

David Rutley: Will the Financial Secretary tell the House about the strong interest being shown across the world in the Government's positive approach to tackling fiscal consolidation? Does not that further confirm that this country is now on the right path to tackling the economic crisis?

Mark Hoban: My hon. Friend is absolutely right. The crisis reminds us of the continuing focus on sovereign debt. The Government have taken clear measures to tackle our fiscal problems, and international bodies have recognised that. It is one of the reasons for Standard & Poor's reporting our credit rating as stable compared with its negative outlook under the previous Government. We are taking the right steps to secure our fiscal position, bearing in mind that the crisis in Ireland is around banking, not the fiscal position.

Gregory Campbell: It is in no one's interests for the Irish Republic's economy to go down even further, but taxpayers in the United Kingdom are worried that the Irish Republic could be next, followed by Portugal, Spain and Italy, and that the full and true extent of what we might have to pay is not known.

Mark Hoban: I do not want to engage in speculation about the eurozone; I do not think that that is very helpful. The hon. Gentleman, like the hon. Member for Foyle (Mark Durkan) and their colleagues, will know from experience in Northern Ireland that we have very strong interests in the stability of the Irish economy, and it is important that we stand ready to help the Irish Government in stabilising it.

Harriett Baldwin: Does the Minister agree that the problem in Ireland is not so much the fiscal measures that it is taking, or global growth, but the fact that it is in the euro, and that as long as Ireland is in the euro it is hard to see how it can work its way through these problems? Would the Minister like to pay tribute to all those on this side of the House who fought to keep this country out of the euro?

Mark Hoban: Indeed, and my hon. Friend makes an important point. We have access to a wider range of economic tools to resolve our problems as a consequence of our being outside the euro. It is also worth bearing it in mind that this crisis flows from the banking sector, not from public spending in Ireland.

Albert Owen: It is right to support our near neighbours in Ireland and their economy. The problem over the past 18 months has been twofold: severe austerity measures and the collapse of the construction industry. Will the Government ensure that we do not follow that path? Will the Minister use the flexibility the Government have outside the euro to ensure that we slow the cuts and do not have the mass unemployment and depopulation that we have seen in Ireland?

Mark Hoban: I thought that the hon. Gentleman almost had it. The crisis in Ireland is around the banking sector, not the fiscal position. I believe that we are taking the right measures to stabilise the UK economy-the cuts we are making in public spending-to get our deficit under control and to keep interest rates as low as possible for as long as possible. Labour Members are the only ones calling for a weaker fiscal position when the world is moving to stronger fiscal stances.

Douglas Carswell: If we are to spend taxpayer money dealing with this crisis, rather than bailing out the euro should we not be helping Ireland to bale out of the euro or, at the very least, to retain her economic independence against the Van Rompuy system of pan-European economic governance?

Mark Hoban: I hear what my hon. Friend says about the crisis. Let me be absolutely clear: no request for support has yet come from the Irish Government. It is important that we ensure that the Irish economy is stabilised-it is in our national interests to do so.

Naomi Long: I thank the Minister for the reassurance he has already provided in not ruling out intervention or assistance should it be required. Will he provide further reassurance that he will give special consideration to the situation in Northern Ireland, where many of the Irish banks to which he refers are operational and indeed on which many of our businesses rely?

Mark Hoban: Indeed, and the hon. Lady makes an important argument about why we need to stand by the Irish Government and provide assistance if they request it.

George Freeman: Can the Minister provide my constituents and the markets with the reassurance that any British involvement will be conditional on the full involvement of the IMF?

Mark Hoban: As no request has been made, I cannot comment on that. Where support is given to economies, it is commonplace for the IMF to be involved.

Gregg McClymont: The Government spent six months telling us that Britain was very much like Ireland and had a similar sovereign debt crisis. Now we hear that we are in a very different position because we are not in the euro and we have other economic tools. Which is right?

Mark Hoban: We have taken action in the UK to tackle our fiscal position to avoid a sovereign debt crisis.  [Interruption.] Opposition Members need to recognise that the problems facing Ireland stem from a banking crisis-the banking sector was poorly regulated. We are learning lessons from that in the UK, but it is very clear that because we are outside the euro we have the flexibility to engage in economic policy by setting interest rates that meet our economic needs, and we have the flexibility that our exchange rate brings in stimulating exports. We are in a much better position as a consequence of being outside the euro.

Matthew Hancock: Would it not be a grave error if we took from this episode the lesson that we should weaken our resolve to deal with our debts and keep our house in order?

Mark Hoban: My hon. Friend is absolutely right. It is noteworthy that Opposition Members have made yet another call for us to put off making difficult decisions. We see in Ireland what will happen if we do not make difficult decisions now and sovereign debt ratings come under pressure.

Ian Davidson: Does the Minister agree that we should thank goodness that Scotland is part of the United Kingdom? Scottish banks were bailed out by the UK as a whole rather than being left to float loose as those in Ireland have been? Does he agree that if, when they are making cuts, the Government can find billions of pounds to bail out Ireland, they could better use that money to ameliorate the effect of the cuts in the UK?

Mark Hoban: As I said, no formal request has been made for assistance. We have a clear national interest in the stability of the Irish economy, and that must be recognised.

Charlie Elphicke: Does not the crisis in Ireland and across Europe underline how right the Government have been to take the tough but necessary action to save us from bankruptcy? Will the Minister condemn the siren voices in Europe that are talking down Ireland, and will he be a friend in need, as we, as a country, should be?

Mark Hoban: My hon. Friend makes a number of very valuable points. If we had not taken tough action when we came into government, when rating agencies had our credit rating as negative, we would not have managed to narrow the spreads on UK debt compared with German bunds and reduce the yields on British debt. All that is testament to the strength of the action we have taken to tackle Britain's fiscal problems and the legacy we inherited from the Labour party.

Hugh Bayley: Has the Treasury considered the implications for sterling if the Republic of Ireland were to leave the euro and seek to re-peg to the pound?

Mark Hoban: That is speculation, and I do not think it appropriate to engage in that at this stage.

Laurence Robertson: In the event of a request for assistance from European funds, does the Minister believe that Ireland should be allowed to set its own rate of corporation tax, with its low rate being a strength rather than a weakness?

Mark Hoban: As I said earlier, a number of aspects of Irish economic policy created growth, but I remind my hon. Friend, and Opposition Members, that the problems facing Ireland stem from a banking system that was not well regulated, which led to an asset price bubble. We have taken the right action in this country to tackle our deficit and to avoid having our credit rating put at risk.

Ian Paisley Jnr: The mechanism established to address bad banking debt in the Republic of Ireland, the National Asset Management Agency, known as NAMA, holds several billion pounds of properties in Northern Ireland and across the rest of the United Kingdom, particularly here in London. What representations are the Government making to protect our economy from NAMA deciding to float that property at the cheapest possible price to meet the needs of the banking sector in the Republic of Ireland, thereby damaging our economy?

Mark Hoban: I hear what the hon. Gentleman says about NAMA. It is not for us to speculate on the policy that should be followed by NAMA or the Irish Government.

Andrea Leadsom: Does my hon. Friend agree that the banking crisis was caused, in large part, by poor regulation? Will he take into account comments made by the City of London corporation to the Treasury Committee yesterday that UK banks believe that the regulatory regime we are putting in place in the UK has elements that are not compatible with the European regulatory regime? Will he take those comments very seriously and try to make sure that Britain's banking sector is properly regulated and not incompatible with the European regime?

Mark Hoban: I have not seen in detail the comments made by the City of London corporation yesterday in evidence to the Treasury Committee, but I am determined that the regulatory reforms that we introduce will lead to a more stable and sustainable financial services sector-and a more stable and sustainable economy.

Andrew Bridgen: Does the Minister agree that the test of any currency is in the tough times, not just the good ones? That was explained to all the countries that joined the euro, many of which, in my view, did so with their eyes wide shut. Is it not abhorrent that this liability, and the failure of the euro, should become a liability to the UK taxpayer at this time?

Mark Hoban: I do think that we have an interest in having a strong, stable eurozone and eurozone economy. Member states will reflect on the measures that need to be taken to strengthen the eurozone; that is part of the thinking behind some of the measures in the economic governance paper proposed by Herman Von Rompuy just a few months ago.

Points of Order

Chris Bryant: On a point of order, Mr Speaker. I am sure that you are aware that on 19 March 1997, the House passed a resolution that included various provisions, one of which is that it is of paramount importance that Ministers give accurate and truthful information to Parliament, and another that Ministers should be as open as possible with Parliament and refuse to provide information only when disclosure is not in the public interest.
	Yesterday evening for some hours, we debated whether the next general election should be held in 2015 or 2014. Of material relevance to that debate were the Government's intentions in relation to the combining of polls in Wales, Scotland and Northern Ireland with the general election in 2015. The Parliamentary Secretary, Cabinet Office, the hon. Member for Forest of Dean (Mr Harper), sat in the Chamber throughout the debate but said nothing until the very last moment at 9.30 pm, when he revealed that he intended to write to the devolved Administrations-I understand that that has already happened-to ask whether they would like a new power.
	That materially affected every single aspect of yesterday afternoon's debate. I believe not only that it was a gross discourtesy to the House for the Minister to have operated in that fashion, but that it offends directly the resolution of the House of 19 March 1997. He said that he will write to the devolved Administrations, and therefore relied on that for part of his argument. Will you, Mr Speaker, ensure that he makes all such letters available in the Library of the House? I realise that it is not within your power to tell him that we cannot have Report stage of the Bill until such time as amendments on elections can be tabled in the elected House-before they can be made in House of Lords-but can you look into whether there has been a breach of that resolution?

Mr Speaker: What I would say to the hon. Gentleman is that ordinarily-as he would expect-the precise contents of the resolution of 19 March 1997 are firmly imprinted on my mind almost as firmly as they are on his. Nevertheless, I am happy to refresh my memory on that matter.
	On the face of it, however, I have a slight suspicion that the hon. Gentleman, who is a very assiduous parliamentarian, is continuing the debate. I am not saying that there is not something upon which I need rule, but that I am not clear whether there is. Ministers can speak when they wish in relation to those matters, including when winding up debates. I sense that the hon. Gentleman is extremely dissatisfied with ministerial silence when he expected a ministerial response. That may be a matter of a point of frustration, and there might even now and again be discourtesy, but it is not apparent to me as yet that there has been a breach of order.
	I know how persistent a terrier the hon. Gentleman is, and I will look into the matter and revert to him, but I do not think that he needs to make another long point of order just yet.

David Heath: Further to that point of order, Mr Speaker.

Mr Speaker: On this matter, the Deputy Leader of the House might be able to provide enlightenment.

David Heath: The hon. Member for Rhondda (Chris Bryant) would be the first to make a point of order had my hon. Friend the Minister released in writing something that should properly have been put before the House-as it was-by him in a debate on the relevant subject. I can think of no better illustration of the proper way for Ministers to behave in relation to the House.

Mr Speaker: I hope that colleagues will understand if I say that at this point, pending any further study, I feel confirmed in my suspicion by that exchange that we are having a continuation of the debate. That may be stimulating, but it is not really within the realms of points of order. Someone who I am sure knows about the realms of points of order on the strength of his 26 years' service in the House is the hon. Member for Stone (Mr Cash).

William Cash: Further to that point of order, Mr Speaker. I am extremely grateful to you for reminding me of that.
	What happened last night was somewhat affected by the fact that the Minister's statement came at the end of the debate. Would it not have been far more convenient and courteous to the House if he had made that announcement at the beginning of the debate? The announcement affected proceedings and the status of amendments that were not debated.

Mr Speaker: The short answer to the hon. Gentleman is that that may or may not be so, but unfortunately, it is not a matter of order. If he or other hon. Members are seeking to increase the powers of the Chair, they must find ways to do so-if he is asking whether I would strenuously resist, the answer is almost certainly no-but within the powers that I have, I cannot do anything about the matter other than to allow him, within limits, to expatiate, which is what he just did.

Barbara Keeley: On a point of order, Mr Speaker. Today we heard the Prime Minister pledge that the Government would stand ready to help the flood victims in Cornwall. That pledge is similar to one that he made to my constituents when we had a terrible gas explosion two weeks ago-200 households were evacuated, and a dozen people were injured, including one very seriously.
	When I tried to follow up on the Prime Minister's pledge to my constituents, his officials said that no help was forthcoming. Is it in order for the Prime Minister to stand at the Dispatch Box in Prime Minister's questions pledging the Government's support to victims of explosions or floods when his officials have no intention whatever of offering any support?

Mr Speaker: Of course, action should always follow words, but if we were to establish that as a total precedent in the House, it would probably create some difficulty. The hon. Lady has put her thoughts very clearly on the record. It was not really a point of order, but she is a pretty ingenious Member, and I have a feeling that she will find other ways, in debate and questioning, to air her views on that subject. I look forward to her doing just that.

Onshore Wind Turbines (Proximity of Habitation)

Motion for leave to bring in a Bill (Standing Order No. 23)

Chris Heaton-Harris: I beg to move,
	That leave be given to bring in a Bill to give powers to local planning authorities to specify the minimum distances permissible between onshore wind turbines of certain dimensions and the nearest habitation; and for connected purposes.
	I am proud to be a Back-Bench Member of a Government who truly believe in localism and removing the top-down, centre-knows-best approach to government that grew out of hand in the past 13 years. Nowhere was that malignant approach more visible to the people who elect us than in how the previous Government forced their views on local areas and imposed massive changes on localities, such as large, controversial housing developments, or even more controversial wind farms.
	My Bill simply gives local people and communities in areas where there are such wind farm proposals a real say on whether they take such developments. Numerous communities up and down the UK will be happy to take on such development, and I strongly believe that this Government's approach of much more carrot, compared with the previous Government's stick, will ensure that more proposals are passed.
	I strongly contend that such developments should be allowed only when the local residents in the affected community have actually had a say-not just when they have been consulted-on the development that will change the nature of the place where they live. I also strongly contend that the best way to save so many communities up and down the country an enormous amount of strife, and at the same time save developers a reasonable amount of money, is to allow each local planning authority to set such minimum distances. Thus everyone will know exactly the state of play in each area.
	That will hopefully eliminate the huge number of speculative proposals in areas where, under normal circumstances, it would be difficult to get planning permission even for a double garage. Many Members will know of the angst that is caused by proposals for massive turbines that are completely out of keeping with the local environment.
	In my constituency, the usual height of a turbine applied for is 126.5 metres. Let me put that into perspective. The tower that supports Big Ben is 96.3 metres or 316 feet to the top of the spire. The London Eye is 135 metres tall. Those two structures dominate the local cityscape. Imagine what a number of structures twice the size of Nelson's column situated close together do to the landscape in the rolling countryside of Northamptonshire or similar, but not quite as beautiful, parts of the country. If hon. Members consider that alongside the problems associated with flicker and noise from turbines, they will understand why local planning authorities are best placed to judge whether areas within their boundaries are suitable for such large-scale developments. Wind turbine operators say that if there is a minimum distance between turbines and dwellings-a distance of 2 km, say-there would be very few areas in the United Kingdom where turbines could be sited. That might be the case, but my Bill does not state what the minimum distance should be; it simply gives local planning authorities the opportunity to determine such distances-hopefully after consulting the people who live in an area-based on local knowledge and local conditions.
	Many hon. Members feel the same way, including my hon. Friends the Members for Hexham (Guy Opperman), for Morecambe and Lunesdale (David Morris) and for Weaver Vale (Graham Evans), who have all followed me on this matter with great interest. In an Adjournment debate in October, the Minister of State, Department of Energy and Climate Change, my hon. Friend the Member for Wealden (Charles Hendry) reflected on the direction of current Government policy, saying:
	"We have seen the benefits from offshore wind, but we recognise that communities often feel concerned that proposed wind farms in their areas will destroy the environment or have other negative impacts. We are convinced that, in the policy of localism that we are going to drive forward, local councils should be the driving force in deciding how they want their communities to develop. That is a fundamental part of the planning changes we are making."-[ Official Report, 13 October 2010; Vol. 516, c. 137WH.]
	I would like to think that the Government will see this ten-minute rule Bill as a helpful nudge in the right direction, and perhaps even try to encompass it in the forthcoming localism Bill, and in doing so put some public confidence back into the planning system.

Martin Horwood: I agree with the commitment to localism shown by the Member for Daventry (Chris Heaton-Harris), and I suspect that there is barely a wafer between us on issues such as regional spatial strategies. However, I rise to oppose the Bill on the grounds that it is unnecessary, unwise and very unlikely to encourage the shift that we need in this country towards renewable energy. Instead, it runs the risk of feeding the irrational objections of a minority who have decided that wind power is bad and who will use almost any excuse to oppose it.
	If hon. Members are in any doubt that this group is a minority, market research is remarkably consistent, with 70 to 80% of the UK population expressing support for wind, partly because wind turbines are probably the most beautiful and graceful form of energy generation, and because they are certainly prettier than the average nuclear power station-something that I understand the hon. Gentleman supports. Interestingly, support for wind power increases with proximity to wind farms. One piece of research showed that among people living near existing wind farms, support rose as high as 94%. That is entirely consistent with the experience in Denmark, which has the highest proportion of onshore wind and wind power in general, at nearly 20%, and the highest public support for wind power, at 93%. Indeed, that figure will probably increase as designs improve and wind turbines become quieter and possibly even more beautiful, as well as probably larger and more efficient.
	The Bill is unnecessary because planning policy statement 22, which is already in force, says that local authorities already have the power to set minimum distances on a case-by-case basis. Paragraph 22 of the statement says quite clearly:
	"Plans may include criteria that set out the minimum separation distances between different types of renewable energy projects and existing developments."
	Indeed, our hon. Friend the Under-Secretary of State for Communities and Local Government, the hon. Member for Bromley and Chislehurst (Robert Neill), whom I am pleased to see in his place, confirmed the position in a reply to the hon. Member for Redditch (Karen Lumley), saying:
	"Under current planning policy distances between wind turbines and dwellings are decided on a case by case basis so that local factors can be taken fully into account. Local planning authorities are already able to set out the criteria they apply in assessing applications for renewable energy development in their local plans provided this does not rule out or place constraints on development without sufficient reasoned justification."-[ Official Report, 1 November 2010; Vol. 517, c. 544W.]
	That seems to strike exactly the right balance between localism and our commitment to renewable energy. The Government's localism Bill will, I hope, increase and enhance the freedom of local authorities to look at such matters freely, on a case-by-base basis. Bills such as this run the risk of undermining that by once again trying to get Parliament to hand policies to local authorities that they are better able to decide for themselves.
	That is unwise, because blanket bans based on proximity are likely to lead to bad policy. If a ban had been in place in my constituency last year, it would almost certainly have prevented our very first wind turbine, which has been placed in Springfield park. It is much smaller than the ones that the hon. Member for Daventry talked about, but it is much closer to human habitation. A blanket rule might have prevented that wind turbine, which will now generate 9,500 kWh of electricity a year, save 4 tonnes of CO2 a year and shave £1,000 a year off the energy bill of the nearby neighbourhood project. If a borough-wide policy had been in place, it would have complicated the process. Presumably the hon. Gentleman might argue that the local community could have tried to overturn that policy, but if it could be overturned, what would be the point of having it in the first place?
	There is also the unintended consequence that might result, which is that the more we restrict wind turbines near to human habitation, the more we encourage them in more rural and more sparsely populated areas. I can see the planning appeals now, in which somebody cites what would be known as the Wind Turbines (Proximity of Habitation) Act 2010 as evidence that a wind farm should go ahead in an area because it falls outside the set distances. The Bill might therefore have precisely the opposite effect from that intended by the hon. Gentleman.
	I am sad to say that I suspect that the real purpose behind the Bill is probably to appeal to the anti-renewable lobby, which seems to be growing. I would have hoped that, in the new situation, both coalition parties had moved on from this kind of politics. We are intending to be the greenest Government ever, and the Bill would sit badly with that ambition. Luckily, as a ten-minute rule Bill, it has little chance of success, so I will not trouble the House with a Division. However, I remain opposed to the Bill.
	 Question put (Standing Order No. 23) and agreed  to .
	 Ordered ,
	That Chris Heaton-Harris, Andrew Percy, Sarah Newton, Natascha Engel, Matthew Hancock, Nigel Adams, Karen Lumley, Alec Shelbrooke, Andrea Leadsom, Mark Pawsey, Mr Richard Bacon and Andrew Griffiths present the Bill.
	Chris Heaton-Harris accordingly presented the Bill.
	 Bill read the First time; to be read a Second time on Friday 10 June 2011, and to be printed (Bill 108).

Opposition Day
	 — 
	[6th Allotted Day]

NHS Reorganisation

John Healey: I beg to move,
	That this House believes that the Government is pursuing a reform agenda in health that represents an ideological gamble with successful services and has failed to honour the pledges made in the Coalition Agreement to provide real-terms increases each year to health funding; further believes that the Government is failing to honour its pledge in the Coalition Agreement by forcing the NHS in England through a high-cost, high-risk internal reorganisation as set out in the health White Paper; is concerned that the combination of a real cut to funding for NHS healthcare and the £3 billion reorganisation planned by the Secretary of State for Health will put the NHS under great pressure and that services to patients will suffer; supports the aims of increasing clinician involvement and improving patient care, but is concerned that the Government's plans will lead to a less consistent, reliable and responsive health service for patients which is also more inefficient, secretive and fragmented; and calls on the Secretary of State for Health to listen to the warnings from patients' groups, health professionals and NHS experts and to rethink and put the White Paper reforms on hold, so that in this period of financial constraint the efforts of all in the NHS can be dedicated to improving patient care and making sound efficiency savings that are reused for frontline NHS services.
	The motion is set in similar terms to the motion standing in the name of my right hon. Friend the Member for Leigh (Andy Burnham), the shadow Education Secretary, which we will debate a little later. That is because in both health and education we are seeing many of the same broken funding promises, much of the same free market ideology, many of the same problems of big changes forced through without considering or caring about the consequences, and many of the same risks that the poorest and most vulnerable will lose out and that comprehensive, consistent public services will be broken up. Beyond the spending cuts, we are starting to see the pattern of what public service reform means in Tory terms.
	The Prime Minister told Britain before the election:
	"We are the only party committed to protecting NHS spending."
	In his coalition agreement with the Deputy Prime Minister, he went further, saying:
	"We will guarantee that health spending increases in real terms in each year of...Parliament".
	The Government whom the Prime Minister leads are now breaking the promises that he made to the British people. The Secretary of State has been caught out double-counting £1 billion in the spending review as both money for the NHS and money to paper over the cracks in social care. Let me quote from a Library research paper, which confirms:
	"Including the (social care) funding is critical to the description of the settlement as a 'real terms increase'; without it, funding for the NHS falls by £500 million-0.54% in real terms."
	There we have it-the facts in the figures. There is no real-terms rise in NHS funding, but a real-terms cut over this Parliament by this Government- [ Interruption. ]
	The Secretary of State says, "Nonsense" from a sedentary position. If he wants to deny the figures in the Green Book, deny the report in the Library research paper, and take issue with the Nuffield Trust, who all say the same, he should do so. He should by all means take credit for funding social care, but he should not double-count the credit by including it for both NHS funding and social care funding.

Andrew Lansley: I do indeed deny that. It is very simple. The total NHS budget will rise in real terms. Resource funding will rise by 1.3% in real terms over four years. Even if the money to be transferred to local authorities were taken out, that is an increase in resource funding for the NHS in real terms.
	The right hon. Gentleman must consider that if a health service buys rehabilitation for patients returning home after being in hospital so that they do not need another emergency hospital admission, or puts telehealth in someone's home so that their independence at home is maintained, that is health spending. It is the normal approach of the NHS to providing preventive services.

John Healey: There is a good case for more funding in social care, but the truth is, as Age UK says, that in this Parliament it will be cut by an average of 7% in real terms. Social care may help the health service, but if money is spent on social care, it is not spent on NHS services, and it cannot be double-counted as NHS funding. When that is taken into account and when the Secretary of State stops fiddling the figures, we see that the country and the NHS will get a real-terms cut, not a real-terms rise during this Parliament.

Andrew Lansley: I have a simple question for the right hon. Gentleman. Is he in favour of the budget that we announced for the NHS, and does he wish to spend more or less?

John Healey: My right hon. Friend the shadow Chancellor said in response to the Chancellor's spending review:
	"We support moves to ring-fence the"
	NHS
	"budget".-[ Official Report, 20 October 2010; Vol. 516, c. 968.]
	People saw Labour's big investment in the NHS bring big improvements-50,000 extra doctors, 98,000 more nurses, deaths from cancer and heart disease at an all-time recorded low, the number of patients waiting more than six months for operations in hospital down from more than 250,000 in 1997 to just 28 in February this year, and more than nine in 10 patients rating their experience of hospital care as good, very good or excellent.

John Baron: How does the right hon. Gentleman account for the fact that the UK is still floundering in the lower divisions of the international cancer league on survival rates?

John Healey: We still have a lot further to go. There have been big improvements in international comparisons, but we must go further. It beggars belief that the Government have decided not to press ahead with plans to give patients a guarantee of, for example, receiving test results within one week, especially as hon. Members on both sides of the House recognise the importance of early diagnosis for cancer, and the cancer specialist, Mike Richards, said that this contribution to early diagnosis could save 10,000 lives a year.
	Instead of building on those great gains, I fear that the NHS will again go backwards under this Tory-led Government. It is already showing signs of strain. The number of patients waiting more than 13 weeks for diagnostic tests has trebled since last year, 27,000 front-line staff jobs are being cut, and two thirds of maternity wards are so short-staffed that the Royal College of Midwives says that mothers and babies cannot be properly cared for.
	This is not what people expected when they heard the Prime Minister say that he would protect NHS funding. In fairness, a proper, long-term perspective is needed on NHS financing. Year-on-year funding just below or even 0.1% above inflation is way short of the 4% average increase that the NHS has had over its 60 years. During the last Labour decade, it averaged 7% in real terms.
	There are, and have been for many years, built-in pressures on the NHS: the cost of staff, drugs and equipment rises by about 1.5% above general inflation, and the demands of our growing and ageing population adds £1 billion to the bill each year just to deliver the same services.

Sarah Newton: It is interesting that the right hon. Gentleman omitted from his list any mention of the escalating costs of administration in the NHS. Does he agree with us that what is really important is to reduce the cost of administration?

John Healey: The hon. Lady is right, and there is plenty of scope to do that. We recognised that, and we had plans to take out many of the managerial costs. I will come to that later, but it is hard to understand how creating three or even four times as many GP consortiums doing the same job as primary care trusts is likely to reduce rather than increase bureaucracy in the NHS. My right hon. Friend the Member for Leigh says that in Wigan there is one PCT, but it is set to have six GP consortiums. The same job will be done six times over in the same area. How is that a cut, or an improvement in the bureaucratic overheads and costs of the NHS?
	In the spending review, the NHS is set for the biggest efficiency squeeze ever. On 12 October, the NHS chief executive, David Nicholson, told the Health Committee:
	"It is huge. You don't need me to tell you that it has never been done before in the NHS context and we don't think, when you look at health systems across the world, that anyone has quite done it on this scale before."
	Money is tight, and something must happen, but that can be done by building on Labour's big improvements in the NHS over the last decade. It will be tough, but I will back the Government, as long as all savings are reused for better front-line services to patients.

Andrew Lansley: Before the right hon. Gentleman continues, may I remind him that the "it" that Sir David Nicholson was talking about was the achievement of between £15 billion and £20 billion of efficiency savings, which is a substantial improvement in productivity that is expected over the next four years? That is in complete contrast with a Labour Government who had declining productivity over the whole of the last decade. The efficiency savings of £15 billion to £20 billion that Sir David was talking about were set out by the last Labour Government in late 2009. We are continuing with that, but we will make it happen, and Labour did not.

John Healey: I have read David Nicholson's transcripts, and he was indeed talking about £15 billion to £20 billion of efficiency savings, which were not achieved, as the Secretary of State said, but planned. That is a big test for the NHS, and it will be more difficult because of his plans for reorganisation, which I will come to.

Andrew George: As I was at the evidence session, I can confirm that Sir David Nicholson was clearly talking about the challenging £15 billion to £20 billion savings, which I would have thought the whole House approved of and agreed should be achieved. But the right hon. Gentleman was right to say that Sir David was also talking about their achieved in the context of the proposed changes in the White Paper.

John Healey: Of course Sir David was talking about the two together, because the Select Committee was understandably probing both matters. In the quote that I gave, he was talking about the significant efficiency savings required of the health service at this time of an unprecedented financial squeeze. Many would say that that is the toughest financial test in the NHS's history.

Stephen Dorrell: Will the right hon. Gentleman give way?

John Healey: Of course I will give way to the Chairman of the Health Committee.

Stephen Dorrell: The right hon. Gentleman is right to say that Sir David was talking about the £15 billion to £20 billion efficiency challenge, and as my right hon. Friend the Secretary of State said, that programme has its roots in the time of the last Government. Will the right hon. Gentleman confirm that his party still supports the QIPP challenge-quality, improvement, productivity, prevention-that was first articulated when his right hon. Friend the Member for Leigh (Andy Burnham) was Secretary of State?

John Healey: If the right hon. Gentleman reads the official record, he will see I have just said that I will back the plans to get the efficiency savings out of the NHS. They are needed and they have to happen, and I will back them as long as all the savings are reused for front-line services to patients.
	Faced with the toughest test in its history, the least NHS patients and staff can expect is that the Government keep their funding promise. At this time of all times, the last thing the NHS needs is a big internal reorganisation. The Prime Minister ruled out such a reorganisation before the election, saying:
	"With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS".
	The right hon. Gentleman, now the Secretary of State, ruled it out, saying that the NHS
	"needs no more top-down reorganisations".
	The coalition agreement was clear and reassuring on this point. In it, the Prime Minister and the Deputy Prime Minister pledged:
	"We will stop the top-down reorganisations of the NHS that have got in the way of patient care".
	That was before the Secretary of State's White Paper plans, which the head of the King's Fund has called
	"the biggest organisational upheaval in the health service, probably since its inception".
	Promise made in May, broken in July. Promise made by the Prime Minister, broken by the Secretary of State.
	There is a story doing the rounds in the media of a journalist being briefed by No. 10, early on the morning of the publication of the White Paper, and told
	"there's nothing much new in it."
	When did the Secretary of State tell the Prime Minister that he was breaking his promise? When did he tell the Prime Minister that he was not only breaking the Government's promise but forcing the NHS through the biggest reorganisation in its history, with a £3 billion bill attached, at a time when all efforts should be dedicated to achieving sound efficiencies and improving care for patients? This is high cost and high risk; it is untested and unnecessary.

Angela Smith: The Public Accounts Committee has identified that improving integration and co-ordination of services for the 580,000 people who suffer from rheumatoid arthritis would deliver efficiency savings on the annual £560 million bill faced by the NHS each year for this care. The National Rheumatoid Arthritis Society believes, however, that the new commissioning responsibilities outlined in the White Paper
	"risk increasing fragmentation in services"
	and reducing savings overall. Does my right hon. Friend agree?

John Healey: In a way it does not matter whether I agree; it matters much more that the National Rheumatoid Arthritis Society and many other patients groups are deeply concerned about this.
	It is not just patients groups but professional bodies and NHS experts who are worried. Even the GPs are not convinced, and they are meant to be the winners in all this. They are meant to be the ones planning, buying and managing the rest of the NHS's services. A King's Fund survey carried out last month found that fewer than one in four GPs believe that the plans will improve patient care, and only one in five believe that the NHS will be able to maintain the focus on efficiency at the same time.

Nick de Bois: In my constituency, we have been holding one-to-one dialogues with GPs, particularly about the White Paper, and I can tell the right hon. Gentleman with total confidence that well over 65% of the GPs I have met-it is only 65% because I have not managed to meet all of them-have endorsed the removal of the PCTs, from which they felt remote and disjointed and from which they felt they were getting poor value for money.

John Healey: If two thirds of the GPs the hon. Gentleman met are in favour, one third are obviously not convinced, but they will be forced to do this anyway. That is part of the problem, and I will come to that in a moment.
	It is no wonder that the head of the NHS Confederation, the body that is there for those who run the NHS, told the Health Select Committee last month that
	"there is a very, very significant risk associated with the project".
	Even the Secretary of State's right-wing supporters in the Civitas think-tank tell him that he is wrong. They have said:
	"The NHS is facing the most difficult...time in its history. Now is not the time for ripping up internal structures yet again on scant evidence".

David Evennett: I have been listening to the right hon. Gentleman with great interest. I know his moderate views on many things, but he misrepresented what my hon. Friend the Member for Enfield North (Nick de Bois) said about the numbers of GPs. Now that targets and top-down management-the centrepiece of the last Labour Government's policies-are being discarded even by those on the right hon. Gentleman's own Front Bench, does he not agree that giving significant freedoms to front-line professionals is a better way forward?

John Healey: Yes, of course; we had been doing that for some years before the election and we had plans to do it after the election, but the fact is that we did not win the election, and the Secretary of State is in power now. He is making the decisions and he is the one who is entrusted with the future of our NHS. He is the one who needs to answer to the House for his plans.
	The problem with broken promises is worse than I have already suggested. The coalition agreement promised:
	"The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs."
	The Secretary of State's plans will do precisely the opposite. He is abolishing the PCTs, not building on the best of what they do.

Barbara Keeley: There is a great deal of talk about reducing bureaucracy and administration, but PCT staff work on issues such as NHS treatment for people with learning disabilities. Ministers have talked about that role continuing, but will those staff not be really worried about their futures now? They will be looking around, and if they see another job, they are not going to wait two years; they are going to jump now, and the PCTs will lose that expertise. It will drain away and the PCTs will be unable to carry out all those important residual functions.

John Healey: This is precisely why those who understand the health service, including those who run it, say that it is going to be so hard, at a time when the NHS has never faced such a tough financial challenge, to see through the biggest reorganisation in its history at breakneck speed.
	Whether on funding, reorganisation or the role of the PCTs, the Secretary of State is doing precisely the opposite of what was set out in the coalition agreement. He is running a rogue Department with a freelance policy franchise, in isolation from his Government colleagues. He claimed on the "Today" programme yesterday that he had been saying all this for four years before the election. So when did he tell people, and when did he tell the Prime Minister, that GPs will be given £80 billion of taxpayers' money-twice the budget of the Ministry of Defence-to spend? When did he tell people that, in place of 150 primary care trusts, there could be up to three times as many GP consortiums doing the same job? When did he tell people that GP consortiums will make decisions in secret and file accounts to the Government only at the end of the year?
	When did the Secretary of State tell people, and the Prime Minister, that nurses, hospital consultants, midwives, physiotherapists and other NHS professionals will all be cut out of care commissioning decisions completely? And when did he tell the Prime Minister that hospitals will be allowed to go bust before being broken up, if a buyer can be found for them? When did he tell people that NHS patients will wait longer, while hospitals profit from no limit on their use of NHS beds and NHS staff for private patients? When did he tell people that lowest price will beat best care, because GPs will be forced to use any willing provider? When did he tell people that essential NHS services will be protected only by a competition regulator, similar to those for gas, water and electricity? And when did he say that he was creating a national health service that opens the door for big private health care companies to move in?

Andrew Lansley: I am grateful to the right hon. Gentleman, who is generous in giving way. It is never an ideal thing to quote yourself, but let me risk doing so:
	"We have been clear about the need for improvement in the NHS: responsive to patient choice; where budgets are in the hands of GPs; where hospitals are set free; where professionals are released from targets and bureaucracy; where the independent sector has a right to supply to the NHS; where competition delivers efficiency; and where patients have the assurance that NHS standards of care are based on the founding principle of the NHS-free at the point of use and not based on the ability to pay."
	I said that in a letter to  The Daily Telegraph on 10 March 2006-four years ago.

John Healey: The real question is why the right hon. Gentleman, if he had these plans, did not tell the Prime Minister and the Deputy Prime Minister when they were writing the coalition agreement what he wanted to do on funding, on reorganisation and on the role of primary care trusts. Why did he allow his Government to make these pledges to the British public in May and then break their promises two months later in the White Paper? Whatever the boss of Tribal health care says about the private health care companies, he described the White Paper as
	"the denationalisation of healthcare services".
	He went on to say that
	"this white paper could result in the biggest transfer of employment out of the public sector since the significant reforms seen in the 1980s."
	This is not what people expected when they heard the Prime Minister tell the Conservative conference last month that the NHS would be protected.

Andrew George: It is incontrovertible that the White Paper contradicts the coalition agreement in respect of top-down reorganisation, but I think we would accept the right hon. Gentleman's criticisms of top-down manipulation of local services a great deal more if he were prepared to accept that the previous Government failed in their attempt to reorganise through independent treatment centres or alternative providers of medical services which were massively expensive and did not necessarily provide better services on the ground. Will the right hon. Gentleman at least acknowledge that the previous Government failed in that regard?

John Healey: The treatment centres, which the hon. Gentleman mentions, helped contribute to bringing waiting times down to 18 weeks and helped to say to the British public, "Whatever treatment you need in hospital, you will not have to wait more than 18 weeks for it." That was a consistent universal promise that we were able to make to patients as a guarantee for the future. That has now been ripped up, and we can see the result as waiting times and waiting lists lengthen. As I said at the start of my speech, my fear is that during this period of Tory leadership, we will see the NHS going backwards.
	As for the hon. Member for St Ives (Andrew George), I understand his problem. He is a Liberal Democrat and I have to say that this health policy bears very little of the Liberal Democrat imprint. The one part of the Liberal health manifesto that they managed to get into the coalition agreement was this:
	"We will ensure there is a stronger voice for patients locally through... elected individuals on the boards of their local primary care trust".
	Within two months, of course, that was not even worth the coalition agreement paper it was written on.

Helen Jones: Does my right hon. Friend agree that there is something else that the Government are not telling us-namely, the huge cost of getting rid of primary care trusts and strategic health authorities in respect of redundancy and getting out of broken contracts? Does he, like me, speculate that many of the people affected will end up working for GP consortiums or private health care firms-a huge cost to the public purse that delivers not one iota of front-line care?

John Healey: Quite so. Estimates of the cost of the reorganisation are up to £3 billion, but we have not had any cost announcements from this Government, who will not tell us how much is going to be spent on reorganisation rather than on patient care. At a time when finances are tight, this is precisely the wrong prescription for the NHS over the next few years.
	It is no wonder that GPs have grave doubts-they trained as family doctors, not as accountants or procurement managers, and they are committed to treating patients, not doing deals over contracts. However, they will be forced to commission services, whether they like it or not; they will make rationing decisions, not just referral decisions for their patients; and they will have to take on the deficits or inbuilt funding shortfalls in their PCT areas. GPs spend an average of eight or nine minutes with each patient. If they plan, negotiate, manage and monitor commissioning contracts in future, they will have no time left to see patients. If they continue to be family doctors, commissioning will be done for them, not by them; it will be done in their name by many of the same PCT managers who presently do the job or by commercial companies that have already started hard-selling their services to GPs. The other day I picked up "The Essential Guide to GP Commissioning" helpfully published by United Health-one of the biggest US-based health care companies in the world.

Sarah Wollaston: Does the right hon. Gentleman realise that not all GPs will have to be involved with commissioning? Does he welcome the efforts the Royal College of General Practitioners to introduce real clinical leadership and tuition for those GPs interested in taking up commissioning, helping them to provide this service?

John Healey: It is a very good thing that the Royal College of General Practitioners is trying to bring the skills of many GPs up to speed because this is a big job for which GPs are not trained and not equipped, and which many do not want to do.

David Tredinnick: Does the right hon. Gentleman recall that we had GP fundholders during the previous Conservative Government, and the doctors managed the budgets all right and increased choice for patients?

John Healey: The GP fundholding experiment took place in a completely different context-within an NHS that still had an area-based plan and still had bodies accountable through the Secretary of State to Parliament. In the end, however, it did not work and we stopped it.

Andrew Percy: Will the right hon. Gentleman accept that there is some kind of ideological disagreement going on in his own mind, given that the last Labour Government did exactly the same thing to head teachers by bringing alternative providers into schools and giving them control over budgets and what services to deliver? Our proposals for GPs are exactly the same-aiming to put in charge the professionals who deliver services and have contact with the people who use them.

John Healey: I gave way to the hon. Gentleman, who I thought was in his place at the start of the debate. In that case, he will have heard me say that one reason for having an Opposition day debate on both health and education is that we see many of the same ideological fingerprints over the plans for education and for health. These are Tory ideological fingerprints, and I hope that this will become clearer as the debate progresses.
	Let us make no mistake: if these changes go ahead, patients will rightly question whether GPs' decisions are about the best treatment for them or about the best interest of the GP budget and consortium business. The public will find "commercial in confidence" stamped over many of the most important decisions taken about our NHS services. Members of Parliament wanting to hold Ministers to account in future when hospitals go bust or there are no contracted services for constituents or there is a serious failure in the system will be told, "It's nothing to do with me".

John Pugh: Was the right hon. Gentleman perfectly happy about the situation under the last Government? When anyone complained in this Chamber about anything happening in their local health economy, they were told rather piously by a Minister that it was a matter for local decision making by a quango that was completely unelected and beyond their control. In what sense were the PCTs in any sense accountable?

John Healey: Part of the problem is that there is so little detail in the White Paper that we simply cannot see how the bodies taking big decisions about taxpayers' money will be accountable to the public. I lost count of the number of times during the last Government when Health Ministers came to this House and to Westminster Hall and had meetings with Members in order to respond to and sort out the problems that their constituents were experiencing with NHS services.
	What the Secretary of State says he wants from the White Paper plan is to put patients first, to improve health care outcomes, to cut bureaucracy and to improve efficiency. These are "motherhood and apple pie" aims. We can support his aims, but we cannot support the action he is taking or the breakneck speed with which he is forcing these changes on the NHS. He wants shadow GP consortiums to be in place by April, and he will remove primary care trusts entirely two years after that. What he is doing is rushed and reckless. Almost every respondent to the White Paper has warned of the risks and said, "Slow down."

Rosie Cooper: Is my right hon. Friend aware that yesterday the Health Committee was told by health service organisations that some London PCTs would close by March 2011? Is anything happening in that regard? We know that there was a suggestion that PCTs would close in 2012, but we heard for the first time yesterday that they might close in 2011.

John Healey: I am very concerned if those plans are being speeded up rather than slowed down, because that would be entirely contrary to the view that has been consistently expressed by patients groups, experts in the NHS and professional bodies in response to the consultation on the White Paper. "Too far, too fast," says the King's Fund. According to the NHS Confederation:
	"It will be exceptionally difficult to deliver major structural change and make £20 billion of efficiency savings at the same time."
	The Alzheimer's Society says:
	"The pace of structural change has the potential to undermine the progress made in services for people with dementia and their families, unless handled carefully".
	Almost every other group representing patients says the same. Even the chief executive of the NHS has written to the Secretary of State saying:
	"Implementing the White Paper will require us to strike the right balance between developing early momentum for change and allowing enough time to properly test the new arrangements. Getting this balance right will be critical to maintaining quality and safety".

Steve Brine: I know that the right hon. Gentleman does not have a policy of his own, but the motion seems to be saying, "It's all become a bit difficult, so let's just put it off." Until when exactly does he propose to put these changes off? Will they be made in the current Parliament, in the next Parliament, or 10 years down the line?

John Healey: The hon. Gentleman is new to the House, but he and his party are in government now. One of the frustrations for me and for other Labour Members is that his party is making the decisions, and is responsible for the future of the health service. Our plans would be different, but this is what the Government are planning.
	The Secretary of State has received the responses that I have quoted. He has been advised to listen, to slow down, and not to risk the future of the NHS in his consultation. However, he is not listening. I hope that the Prime Minister is listening, for the sake of the NHS, its patients and staff, and for the sake of us all.
	Here is a "thought for the day" for the Prime Minister. The Tories worked hard to be trusted by the public with the NHS before the election. The Government's reckless big-bang reorganisation at a time of tough financial pressures in the NHS will wreck their reputation, but that is the Prime Minister's problem. My problem is that he is set to wreck the great NHS gains made for patients over the last decade, and to wreck the founding principle of our NHS: that it should be available equally to all, free at the point of need, and properly funded through general taxation. We on the Labour side of the House will not allow him to do that.
	I commend the motion to the House.

Several hon. Members: rose -

Dawn Primarolo: Order. Some 15 Members are seeking to participate in the debate. Mr Speaker has therefore decided that there will be a seven-minute time limit on speeches after the Secretary of State has spoken. I remind Members that they do not have to speak for as long as seven minutes; seven minutes is the maximum. If they bear that in mind and are considerate to other Members, it may be possible for everyone to contribute.

Andrew Lansley: I will ask the House to reject the motion.
	As I listened to the speech of the right hon. Member for Wentworth and Dearne (John Healey) I was very disappointed, because it seemed to be all about primary care trusts rather than about patients, all about managers rather than about doctors and nurses, and all about processes rather than about outcomes. It was completely the opposite of what the White Paper sets out to do, which is to give patients control of health care and allow more shared decision making for patients.
	The White Paper is all about focusing on improving health care outcomes, and about empowering the doctors and nurses who work in the health service and recognising the contribution that they make. I am really disappointed that the Opposition motion does not recognise fully, as it should, the role that should be played by patients and staff in the NHS. I advise the right hon. Gentleman, when he tables motions such as this, always to think more about the staff of the NHS and the patients whom they look after, and less about the managers and the processes.
	I will give way to the right hon. Gentleman if he wishes, but let me tell him this. Fighting a campaign called "Save the primary care trusts" will cut no ice with the people of this country. Fighting a campaign to save our NHS is what we did in the last Parliament; we did it successfully, and now that we are in government, saving the NHS is exactly what we are going to do.

John Healey: If the Secretary of State-who, I concede, has a six-and-a-half-year head start on me in this job-really cared about NHS patients, really cared about NHS staff and really cared about NHS services, he would not be putting the NHS through the biggest reorganisation in its history, especially at this time. As I said earlier, it is patients groups and bodies representing NHS staff who are saying, "Slow down-think again." I urge the Secretary of State to do that today, and to rethink.

Andrew Lansley: The right hon. Gentleman has just taken to heart the old saying that the job of the Opposition is to oppose. That is all he is doing: he is simply opposing. Nothing in his motion states positively what should be done, whether that is supporting NHS staff or listening to patients and giving them the shared decision making opportunity that is so essential. While opposing the reforms that we in the coalition Government are introducing, he seems to have ignored the simple fact that those reforms, in truth, represent the coherent consistent working out, in practice, of policies that were initiated, but never properly implemented, by the Government of whom he was a member. They are not revolutionary, as he has called them.

Andrew George: As the right hon. Member for Wentworth and Dearne (John Healey) said earlier, the seventh point in the coalition agreement begins with the words:
	"We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust...The remainder of the PCT's board will be appointed by the relevant local authority or authorities".
	Was the Secretary of State consulted before those words were included in the agreement? If he was, what changed his mind between the drawing up of the agreement and the White Paper?

Andrew Lansley: The answer to the first question is yes. The answer to the second question is that we in the coalition Government collectively took the sensible view that form must follow function. If we arrived at a point at which people were being elected to primary care trusts which themselves no longer had a substantive role to play, because public health was rightly being transferred to local authorities-

Liz Kendall: Did you know that at the time?

Andrew Lansley: We did know that at the time.  [Interruption.] I will not engage in a conversation with the hon. Lady when she is intervening from a sedentary position. I am replying to my hon. Friend the Member for St Ives (Andrew George).
	If we arrived at that point-a point at which GP-led commissioning consortiums were rightly leading on the commissioning of health care services-we would then find ourselves suggesting the election of people to a body that did not exercise any substantive responsibilities.
	We therefore made a collective decision not to implement the policy in that way. The principle that we were pursuing was the strengthening of local democratic legitimacy in relation to health care-and, for that matter, social care-and that is exactly what we are going to do. We are going to do it through the health and well-being boards, and through the local authorities that are directly responsible for the provision of health improvement plans in their areas, engaging directly with local GP consortiums in the strategic commissioning functions and increasingly integrating health and social care.
	Let me return to the point that I was making to the right hon. Member for Wentworth and Dearne. He ought to recognise, but does not seem to understand, that when I was announcing our intentions in 2006, the Government of whom he was a member were saying that these were the reforms that they wished to pursue. Tony Blair made a speech in June 2006 in which he said that NHS reform should be based on patient choice, independent sector providers, general practice-led commissioning and foundation trusts, yet the right hon. Gentleman's motion today has left all that out. All those things that the Labour Government once supported, he, in opposition, now opposes.
	The right hon. Gentleman's motion is notable for what it has left out: it has left out the call for patient information and choice; it has left out any reference to the need for improving health outcomes; and it has left out a recognition, which the House should always reiterate, of the commitment of health and social care staff to the patients they care for. Particularly tellingly, it has also left out any indication of whether Labour supports or opposes our health service spending plans.
	The right hon. Member for Leigh (Andy Burnham) has left the Chamber, but before the spending review he said to us, "Don't protect the NHS budget; cut the NHS budget and transfer it to social care." We did not do that; we did not do what the Labour party suggested. Instead, we have both protected the NHS budget and supported social care.
	Before the election, the Labour Administration said, "Cut NHS capital budgets by 50%," but the real-terms reduction in NHS capital budgets will be just 17%. They said, "Protect the primary care trust budgets but cut central budgets; cut research and development in the NHS; cut education and training," but we are not doing that. We are protecting the resource funding for the NHS, and it will increase in real terms.

Several hon. Members: rose -

Andrew Lansley: I will give way to the hon. Member for Worsley and Eccles South (Barbara Keeley) first, and then to my hon. Friend the Member for Bexleyheath and Crayford (Mr Evennett).

Barbara Keeley: The Secretary of State talks about protecting social care, but he must be aware that at the same time cuts of 28% are being made to local council budgets, of which social services and social care account for the largest component. Even before the comprehensive spending review, six or seven councils were already saying their situation was moving from moderate to substantial, and for one council that has now risen from substantial to critical-and that is before the Government implement their cuts of 28%. There is no such protection in place, therefore. Instead, this radical NHS reorganisation is happening at the same time as those huge council budget cuts, and next year will be terrible. My right hon. Friend the Member for Leigh (Andy Burnham) was right to protect social care, as well as in the other things that he did with the NHS.

Andrew Lansley: The hon. Lady is simply completely wrong. Local government budgets are not being cut by the figure she cites. The formula grant from central Government is having to be cut because of the debt we inherited from Labour, although she, like the rest of her party, is in denial about that, but that does not mean a cut-

Barbara Keeley: Will the Secretary of State give way?

Andrew Lansley: No; I am addressing the point that the hon. Lady made. That cut in formula grant does not mean a corresponding cut in council tax, so that revenue is available to local authorities. In addition, the NHS is going to support social care activity in the ways I have described, such as through telehealth, re-ablement and equipment adaptations. We are transferring the learning disability transfer grant and other adult social care grants collectively representing £2.7 billion a year from the NHS to local authority funding, without reductions in those grants. I am afraid the hon. Lady is just simply wrong, therefore.

David Evennett: I congratulate my right hon. Friend on his determination to improve our national health service, and on the initiatives that he is proposing. However, does he agree that in enabling the NHS and social care services to work more closely together, it is vital to have integrated cost-effective services, and make sure that the patients get the best out of the system?

Andrew Lansley: My hon. Friend is absolutely right. The Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), and I are very impressed that the local NHS and local authorities are, sometimes for the first time, sitting down together and discussing how they can use their resources. Even this year we managed to save £70 million from the budget that we inherited from the Labour party. That money can be invested in re-ablement, and in bringing local authorities and the NHS together to improve the service to people who are going home.

Chris Bryant: Will the Secretary of State give way?

Andrew Lansley: I want to make a little progress first.
	The Opposition motion reveals that they have no alternative vision. The Labour party today is empty of ideas, confused and incoherent. It did not have anything to offer the country at the general election, and it has nothing to offer today. I will deal with each of the points made by the right hon. Member for Wentworth and Dearne, but first I want to say something about what we are doing through the White Paper, and why we are doing it.
	We should be proud of the fundamental values of the NHS: that it is free at the point of use, and that it is based on need and not on the ability to pay. Nothing that we do will ever undermine those principles; that is the coalition Government's commitment. However, our pride in these values is no excuse for complacency. The demands facing the NHS over the coming decades are many: an increasing and ageing population; continued advances in medicine and technology; and rising expectations on the part of patients and the public. That is why, as we maintain equity in access to services, we will also pursue excellence in health care. We will do so because despite the great improvements in the NHS in the past-such as in cardiac surgery and cardiology, and, more recently, in stroke care and many cancer services-we have much more still to do.
	Outcomes for patients in this country are too often poor in comparison with outcomes in other countries: someone in this country is twice as likely to die from a heart attack as someone in France; survival rates for cervical, colorectal and breast cancers in this country are among the worst in the OECD; and premature mortality rates from respiratory disease are worse than the EU-15 average. Simply putting more money into the system has not worked, which is why reform is needed.

Chris Bryant: I am grateful to the Secretary of State for giving way. He has argued the need for greater localism and for local health services to be more accountable to local people. However, pulmonary hypertension is one condition in which significant advances have been made in recent years. It affects a number of my constituents but it is a rare condition, and has to be managed not locally but on a country-wide-indeed, often a Wales and England and Scotland-wide-basis. How can the Secretary of State make sure that, with the pressure towards local services, proper account is also taken of conditions on which action can be delivered only on a national basis?

Andrew Lansley: For England, the White Paper sets out very clearly that specialised commissioning, whether currently regional or national, will be undertaken through the NHS commissioning board, rather than by individual commissioning consortiums.
	The point about the reform process is that if we change nothing, nothing will change. The Labour party is the party of no change: it is the party of stasis, inertia and inactivity. Labour says, "Do nothing, put the reforms on hold"-whatever that means. Our aim is a simple one. We cannot stand still. If we carry on as we are, resources will, as over the last decade, be consumed without delivering the improved outcomes for patients that are so essential. Delivering improved outcomes for patients is our objective, and the White Paper gives us a clear and consistent vision for achieving that, based on three guiding principles.

Frank Dobson: Will the right hon. Gentleman give way?

Margot James: Will my right hon. Friend give way?

Andrew Lansley: Of course. I will give way first to my hon. Friend.

Margot James: The Secretary of State was discussing the disappointing cancer survival rates. A National Cancer Intelligence Network survey was conducted earlier this week, and I was shocked to learn that it found that one in four cancers were diagnosed only when a patient was rushed to hospital experiencing symptoms. Does the Secretary of State think ring-fencing the public health budget and co-ordinating it better with local authorities will enable us to make a swifter impact in respect of the preventive aspects of cancer management, in order to reduce that figure?

Andrew Lansley: Yes, I feel that it should. When the NHS last came under financial pressure in 2005-06, public health budgets were cut and public health staff were lost, but we are determined to address the worrying situation that my hon. Friend described. That is why we are committed to the implementation of a cancer signs and symptoms campaign. It will be launched in the new year, and its purpose is precisely to ensure that we tackle the lack of awareness of cancer symptoms, so that people will present to their GP earlier and we can bring them to diagnosis sooner.

Several hon. Members: rose -

Andrew Lansley: I said I would give way to the right hon. Member for Holborn and St Pancras (Frank Dobson), if he still wishes to intervene.

Frank Dobson: The right hon. Gentleman said that he wanted to improve treatment. How does he think the treatment of sick children at Great Ormond Street hospital will be improved if it has to do without the £16 million that his Government are currently threatening to take away?

Andrew Lansley: I explained to the right hon. Gentleman at health questions just a fortnight ago that we are in discussions with the specialist children's hospitals. They are very clear that they are engaging constructively with the Department, with the intention that the payments through the tariff should accurately reflect the costs incurred in providing specialist services. That is the current situation, and no decision has yet been made.
	I was talking about the principles of the White Paper.

John Healey: Will the Secretary of State give way?

Andrew Lansley: In a moment; the right hon. Gentleman must allow me to make some progress.
	I was talking about the principles of the White Paper. They are very clear. First, patients should be at the heart of the new national service, with a simple principle of "No decision about me without me" transforming the relationship between citizen and service.
	Secondly, we will focus on outcomes, not processes. We will focus on outcomes that capture the entirety of patient care, and quality standards and indicators that genuinely reflect what a high-quality service should actually deliver. We will orientate the NHS towards focusing on what really matters to patients, not narrow processes. Thirdly, we will empower clinicians, freeing them from bureaucracy and centralised top-down controls, so that change is genuinely driven from the grass roots, rather than driven, top-down, from above.
	The right hon. Gentleman's speech did not appear to recognise that central principle at all when he talked about people in the NHS Confederation and the managers who run the NHS. Clinicians are already the people who actually do the commissioning: general practitioners make the referrals and write the prescriptions, and consultants in hospitals make referrals from one consultant to another. In effect, cost and commissioning in the NHS is already controlled by clinicians, but they are divorced from the processes of combining the management of patient care with the management of resources. Whether in this country or in others around the world, it is perfectly clear that that divide is what breaks health care systems. What makes health care systems more effective is bringing together the management of patient care with the management of commissioning and resources on behalf of patients.

John Healey: I wanted to intervene to discuss what my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) said about Great Ormond Street hospital. I have the official record of what was said at health questions, to which the Secretary of State referred. He said that the proposal would have
	"the overall effect of reducing Great Ormond Street's total income by less than 2%."-[ Official Report, 2 November 2010; Vol. 517, c. 754.]
	How does he reconcile that with the trust's figures, which say that the reduction will not be less than 2%, but will be more than 5.5%? Would he like, therefore, to correct the official record now? Will he also publish the figures so that this House and Members who represent these areas can make up their own minds about whether those big stealth cuts to the hospitals that treat many of our most critically ill kids are a good idea?

Andrew Lansley: No, I will not do those things, because what I said was accurate. The specialist children's hospitals and ourselves are engaged in a constructive process of discussion about the future of the tariff for those hospitals, and the top-up, should be. Until a proposal is made there is no purpose in informing the House. We will inform the House as soon as we are in a position to say what the tariff for next year looks like.

John Baron: I totally commend the Government for their focus on cancer reform and improving outcomes. I accept that this is in the melting pot at the moment, but does my right hon. Friend agree that it is important that the one-year and five-year cancer survival rate figures are presented not as a league table but as a performance table, to ensure that all primary care trusts and GP consortiums are tasked with improving performance, irrespective of how they compare with others?

Andrew Lansley: Yes, my hon. Friend makes a good point. What we are looking for is not a league table at all, as health care should not be regarded in that way; we are looking for proper benchmarking to take place. We are going to benchmark this country's performance against that of the best health care systems around the world-the Labour party never did that-and we are going to ensure that there is a culture of continuous improvement in the NHS in respect of both the one-year and the five-year cancer survival rates, which my hon. Friend rightly mentioned.
	The reforms that I was talking about are not a radical departure from the past. The principles of the White Paper should be what the NHS has always been about, but it has been distracted too often by the bureaucratic processes that the Labour party was always supporting. Let me make it clear that many of the things that we are doing were championed by former Labour Ministers. When John Reid was Health Secretary he championed patient choice, and we know why. His view was, rightly, that in the NHS, in a bureaucratic system, the articulate middle classes get access to the best health care, and it is only through institutionalising and embedding patient choice-shared decision making for every patient-that we will ensure that the most disadvantaged in society get the right access to health care.
	As for GP-led commissioning, the Labour party was supposed to have introduced practice-based commissioning.

Rosie Cooper: rose-

Andrew Lansley: I am not giving way, so the hon. Lady must sit down.  [Interruption.]

Dawn Primarolo: Order. The Secretary of State is indicating that he is not giving way, and that is his choice.

Andrew Lansley: Not only is it my choice, but it is a necessity. As you said earlier, Madam Deputy Speaker, 15 Members wish to speak in the debate, and they will be allowed only seven minutes. I shall therefore take less time than the shadow Secretary of State did.
	The Labour Administration pursued practice-based commissioning. Labour Members now make up numbers about how many GP-led commissioning consortiums there will be, but under practice-based commissioning there are 909 practice-based commissioning consortiums-the Labour Government did not give them any power, but they established them and they all have costs associated with them; there are 152 primary care trusts. Bureaucracy and cost in the system is legion, and we have to take it out; we have to reduce the number of people.
	Under the Labour Administration the number of managers and senior managers in the NHS doubled. Where was the corresponding improvement in outcomes? The number of nurses increased by only 27%. That shows the kind of distorted priorities that were at the heart of the previous Government. They said that all NHS trusts should be foundation trusts by December 2008, but they simply did not bring that about; we are going to make it happen. They set up the idea of a right to request for staff in PCTs in provider services to become social enterprises, but we are the ones who are now bringing that about. Yesterday, I was able to announce 32 more social enterprises in the NHS, where staff are taking responsibility and ownership of the service that they provide, representing 15,000 additional staff and more than £500 million of revenue. If the Labour party is now against all the reforms that used to be part of the process of delivering greater empowerment of staff and patients in the NHS, what is it in favour of? I simply cannot find out the answer to that question any more.
	What does represent a radical departure from the past is the fact that we are pressing ahead with the reforms with purpose and pace. I make no apology for the fact that we are going to achieve the changes required in the NHS more rapidly than anything that the Labour party did in the past-because not to do so would prejudice the opportunity to deliver resources to the front line, choice for patients and clinical responsibility for leaders across the NHS.

Kevin Barron: On at least two occasions in the House since the general election, the right hon. Gentleman has cited the Health Committee report on commissioning that was published in March, and used my name, as that Committee's then Chair, to suggest that the report supports his changes in commissioning in the White Paper. Will he confirm that it does not do that? Where is the evidence that the change in commissioning will save any money?

Andrew Lansley: What is very clear from the Health Committee's report before the election is that, as the right hon. Gentleman knows, it criticised in strong terms the weaknesses of PCT commissioning, and that position has only been reinforced since then. One such example is out-of-hours services, for which PCTs were supposed to be the commissioners but did not properly scrutinise the services being tendered, and did not monitor the contracts or the quality of the contracts. PCTs have too often been responsible for simple cost and volume commissioning. What we are concerned with, because we shall engage clinical leadership in the commissioning of services through the NHS, is being engaged in commissioning for quality. Patients will be able to exercise choice based on real information that tells them about the quality of the services being provided, not the cost and volume-

Kevin Barron: rose -

Andrew Lansley: I have already given way to the right hon. Gentleman, and I am now going to conclude rapidly.
	Contrary to what the right hon. Member for Wentworth and Dearne said, we have heard organisations from right across the NHS supporting the principles of the White Paper. The British Medical Association says that it
	"strongly supports greater clinical involvement in the design and management"
	of the health service.
	The Royal College of Nursing said:
	"The principles on which the proposed reforms are based-placing patients at the heart of the NHS, focusing on clinical outcomes and empowering health professionals-are both welcome and supported by the RCN."
	The King's Fund said that it
	"strongly supports the aims of the White Paper".
	The National Association of Primary Care described the White Paper as
	"a unique opportunity to raise the bar in the commissioning and delivery of care for patients."
	The chairman of the NHS Alliance said that it provides
	"a unique opportunity for frontline GPs... to make a real difference to the health of their patients"
	The Foundation Trust Network said:
	"the vision for the NHS articulated in the White Paper is the right one-putting patients and carers at the centre".
	The right hon. Member for Wentworth and Dearne made a number of specific points. He said that the reforms were an ideological gamble. Well, if they are, they are based on an ideology once shared by the Labour party. And if there is an ideology, it is the belief that patients and clinicians in the health service know best. That is not a gamble at all; it is a certainty.
	The right hon. Gentleman talked about reorganisation, but he did not say that the number of managers in primary care trusts rose all the way through to last year in the face of the impending crisis in finances over which the Labour Government presided. He did not tell us that last year primary care trusts spent £261 million on consultancy-an 80% increase in such expenditure in two years.
	The right hon. Gentleman gave us the benefit of some of his figures-some of his dodgy numbers-so let me give him a real number. Our decisions to cut the cost of management and administration in the NHS will release £1.9 billion of savings a year by 2014-15. That money will be reinvested directly to support front-line care, so there will be not only a real increase in the resources available to the NHS, but a real change and increase in the resources that get to the front line, because we are cutting the costs of administration and back offices.
	Let me make this clear-

David Lammy: Will the right hon. Gentleman give way?

Andrew Lansley: No.
	Against all the advice from the Opposition, we protected the NHS budget in the spending review. It was a brave decision for a Government to take in such circumstances, but it underlined our commitment as a coalition to the NHS. It was a decision that went contrary to the advice and recommendations of the Opposition. For the right hon. Member for Wentworth and Dearne to try to attack the Government over "cuts"-he used that word-in the present circumstances is pure opportunism.
	The right hon. Gentleman will not say whether he backs our NHS budget. He talked about what the shadow Chancellor is supposed to have said, but it was the shadow Chancellor who specifically said that he did not support our proposals to increase the NHS budget. Does the right hon. Member for Wentworth and Dearne support our cancer drugs fund or not? He did not say. Does he back our integration of health and social care and the resources that we will use through the NHS to support social care and local authorities? He has not said.
	The right hon. Gentleman has not said whether the Opposition oppose or support our commitment to the NHS. How could he? The Leader of the Opposition said before the spending review that he would publish his alternative proposals, but he never did so. The Opposition were promised it, but it did not happen. Without a plan for the economy and for public services, the right hon. Member for Wentworth and Dearne can say nothing about the NHS.
	Our commitment to the NHS is clear. We have made tough choices on public spending so that we can protect the NHS and ensure that the sick do not pay for Labour's debt crisis-

Frank Dobson: Will the right hon. Gentleman give way?

Andrew Lansley: I gave way to the right hon. Gentleman before.
	The big gamble is not pressing ahead with reform; the gamble now would be to carry on as the last Government did, failing to implement the reforms that are necessary and desirable-and supported-across the service. The spending review and the White Paper give the health service a clear, practical, evidence-based framework for sustained improvement in the future. We will not go back to the days of top-down Whitehall micromanagement and bureaucracy. We will free the NHS to improve outcomes for all patients and to meet our vision of ensuring that health outcomes for the people of this country are among the best in the world. I urge the House to reject the Labour party's motion.

Paul Blomfield: I want to focus on one specific part of the Government's plans, which has already been mentioned by a couple of my hon. Friends and by the former Secretary of State for Health, my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). It is the funding of our children's hospitals.
	I am fortunate enough to have at the heart of my constituency Sheffield children's hospital, which is a centre of excellence for the region and for the country. It offers pioneering services in trauma and orthopaedics, it is a regional centre for the whole of the north of England for burns injuries and the principal treatment centre for South Yorkshire for childhood cancers, and its metabolic bone service is accessed from across the UK. It does a superb job treating some of our most critically ill children and I want to use one example to bring to light the importance of its work.
	A young girl was left unconscious on the streets of Derbyshire with devastating brain injuries after being hit by a car. She was 13 years old. She was transferred to the hospital's intensive care unit, where a scan revealed the full extent of her head injuries. She was seen to have diffuse axonal injury, one of the most devastating types of traumatic brain injury and, as the Secretary of State will know, a major cause of long-term unconsciousness. She was moved to the children's hospital's neurosciences unit, which has specialist equipment to support her rehabilitation and expert consultant neurosurgeons-these are crucial points. Her mother said:
	"The doctors and nurses were wonderful and really did go above the call of duty to provide the very best care and treatment. The ward manager was like a second mum to her. The team cared for her like a member of their own family. She is now back at home, relearning simple things such as walking and talking. There is a long road ahead, but if it was not for the Children's Hospital she wouldn't be here."
	Such cases involve staff from many disciplines and services to ensure that the patient makes the best recovery possible. Neurosciences are one of the trust's flagship services, treating children who have suffered brain injuries or who have other brain conditions, spinal cord conditions, diseases such as meningitis or conditions such as epilepsy. The intensive care unit is part of the hospital's state-of-the-art critical care facility for children and is situated alongside high-dependency and neonatal surgical units, meaning that all the critical care services are in close proximity.
	Such services come at a cost, however, and I have always understood that that is why we have had a top-up tariff to pay for the extra staff and the additional support needed to provide that specialist care to very young patients. We now understand that the Government plan-they might be in discussions, but we understand that this is the plan-to cut the tariff to less than a third of its current value.

Lyn Brown: Does my hon. Friend agree that that puts a whole new slant on the saying, "Women and children first"?

Paul Blomfield: I certainly would. To cut the tariff from 78% to 25% is the most outrageous proposal on health care to have come from this Government.
	When questioned on this issue-this is extraordinary-a spokeswoman from the Department of Health said, very casually,
	"less than 10 hospitals are likely to be affected significantly by these changes and the tariff is not their only source of income."
	We are talking about 10 of the leading hospitals that care for our children. Let us be clear: the Sheffield Children's NHS Foundation Trust has estimated that the change could cut its budget by as much as £4.9 million. That is a reduction of almost 10% in its total funding. It has said that that
	"would have a serious impact on the hospital finances and ability to deliver some services."

Gordon Birtwistle: I am very pleased that the hon. Gentleman has an excellent hospital in his constituency. Will he advise me why the Labour party set in train the closure of Burnley's children's ward when it was in power, leaving an area of Burnley, Pendle and Rossendale and more than 250,000 people without a children's ward, never mind a children's hospital?

Paul Blomfield: I can certainly talk at length about the enormous investment that we made in our hospitals and health services and about the tremendous difference that that made to patients and to reducing the waiting lists that we inherited in 1997. However, I want to make the point about the impact on Sheffield children's hospital. As the hospital said, the change will have a serious impact on its ability to deliver services that provide critical interventions for those whom we should be protecting most-our children. If the Government are prepared to attack these budgets in such a way, what will the commitment to guarantee health spending increases in real terms in each year of this Parliament be other than another broken promise?

Stephen Dorrell: In the brief time available, I do not want to follow the hon. Member for Sheffield Central (Paul Blomfield) in a detailed discussion of children's hospitals, but I congratulate him on the first part of his speech, because he reminded us of what we are here to talk about-the delivery of high quality care to patients, often in circumstances of extreme distress to them and their families.
	I welcome the fact that the debate is taking place, but it is important for us not to imply that there is a choice to be made by politicians in 2010 about whether the health service faces the need for fundamental reform. The truth is that the health service, by which I mean the pattern of delivery of health care to patients, needs fundamental reform, as has been acknowledged since at least 2009. The shadow Secretary of State was good enough to confirm in his contribution that he recognises the need for that fundamental reform, which was set out by Sir David Nicholson in the £15 billion to £20 billion efficiency challenge. The purpose of the Nicholson challenge is to reconcile continuing rises in demand for health care, which we must assume will continue their long-term trends, with the inevitable fact that health budgets are more constrained, and will be more constrained in the years ahead, than during the period of the Labour Government. That was recognised before the general election, which is why the Nicholson challenge was articulated.

Diana Johnson: But does the right hon. Gentleman agree that instead of taking such a big gamble with the NHS at this stage, it would be better to pilot some of the initiatives and changes to see whether they actually deliver better health outcomes?

Stephen Dorrell: I shall come to the White Paper later, but I want to focus on what I regard as the key, unavoidable reforms that have to be delivered during this Parliament. I do not think the hon. Lady will find them controversial. They are the continued development of improvements in the delivery of primary care; the priority need to address unnecessary admissions to hospital, which have been identified by the National Audit Office as running at 30% of non-emergency hospital admissions; the need to address the requirement the health service faces to use its most expensive resource, clinicians' time, more effectively; the need to improve links between social care and health care, because if they do not work effectively there is no way we can deliver the aspirations we all share for high quality care delivered by the national health service; and the need to deliver better patient, user and local community involvement in the design and delivery of health care.
	All those things are the challenges the health service faces over the lifetime of this Parliament. They are not a matter of political choice; they were articulated by Sir David Nicholson during the previous Government. They were endorsed by the previous Secretary of State and this afternoon they have been endorsed again by the shadow Secretary of State. It is simplest to summarise them by describing them in total as the need to deliver a 4% efficiency gain through the entire national health service system for four years running.
	A few weeks ago, when Sir David Nicholson was before the Health Committee, which I have the privilege to chair, we asked him to set that challenge in context and he described it-as the shadow Secretary of State was right to say-as the most substantial challenge not just anywhere in the public service, but anywhere in the economy. The challenge has no precedent in any advanced health care system in the world. The challenge is huge: a 4% efficiency gain throughout the NHS, four years running. We are looking to deliver a wholly unprecedented efficiency gain. Against that background, what is the importance of the White Paper?
	I ask the House to consider for a moment the counterfactual. Is it possible to deliver that kind of efficiency gain in the health service without effective empowered commissioning driving change? If effective empowered commissioners will not do it, who on earth will? Secondly, is it possible to imagine effective empowered commissioning that does not engage the clinical community in the process more effectively than we have yet done?

Simon Danczuk: If there is a requirement for more clinical involvement-for GPs to be more involved in commissioning-why do the Government not simply put GPs on the boards of primary care trusts? That would be a simpler, easier solution and would not cost as much. Is it not the case that the Government would rather open up commissioning to the private sector? Is that not the reality of their proposals?

Stephen Dorrell: I cannot summarise the Government's proposals in the White Paper in three minutes, but one of their key drivers is to deliver far greater clinical engagement in the commissioning process than was achieved in the lifetime of the previous Government, in my time as Secretary of State or at any time in the 20-year history of health service commissioning. We want to achieve a step change in the engagement of the clinical community in the commissioning process. As long as commissioning is something that is done to clinicians by managers, it will fail. It has to engage the clinical community on both sides of the argument. That, as I understand the Secretary of State's White Paper, is one of his core objectives, and if it is, it has my full-hearted support.

Grahame Morris: In advancing that idea, does the right hon. Gentleman accept that the power to commission is being given to clinicians only in primary care, and that clinicians who work in a hospital setting are not being empowered or involved in the commissioning process at all?

Stephen Dorrell: The hon. Gentleman is a fellow member of the Select Committee and I know from our discussions that the principle of clinical engagement in commissioning is broadly supported in the Committee. It is fair to say that none of us would support the view-I suspect the Secretary of State would not either-that clinical engagement means only GP engagement. We should see the GP as the catalyst for broader clinical engagement in the commissioning process if we are to deliver our objectives.
	To deliver the Nicholson challenge, we must have strong commissioning, with clinical engagement, and we have to remove unnecessary processes that do not add value. We cannot afford to waste money on them. We must have greater local accountability for the commissioning process in order to embrace public support for change on this unprecedented scale.

John Pugh: rose -

Stephen Dorrell: I have only 40 seconds left for my speech, so if my hon. Friend will forgive me I should like to conclude.
	My key message is that as we look at the lifetime of this Parliament, I do not see the White Paper as the linchpin of reform, but as a key tool in the delivery of the reforms that are neatly encapsulated in what I have described as the Nicholson challenge.

Rosie Cooper: I often comment that when I became an MP I did not get two items that would have made life so much easier-tarot cards and a crystal ball. In considering the coalition Government's health policy, they would be essential tools for the job, because before the general election, the statements of the Leader of the Opposition-now the Prime Minister-gave us the impression of a future for the NHS that was completely different from the one we are now faced with. He said:
	"We are the only party committed to protecting NHS spending...I'll cut the deficit, not the NHS."
	He spoke about a period of organisational stability in the NHS. Those were broken promise No. 1 and broken promise No. 2. Instead, we are faced with a vision from the Secretary of State which could set us back 20 years. I say so not as political rhetoric, but from 30 years' direct involvement in the NHS, including 10 years as chair of a hospital.
	The press seems to share that pessimistic view-"extraordinary gamble," "cocktail of instability," "accident waiting to happen"-hardly a ringing endorsement of the Government's health policy. For me, it is a recipe for disaster: one part reduced financial resources, two parts structural reform and three parts break-neck speed-

Lyn Brown: Does my hon. Friend agree that the estimated cost of £2 billion to £3 billion for the reorganisation could be far better spent on outcomes for our citizens and treatments for our children?

Rosie Cooper: Absolutely. I am sure the Secretary of State will give due cognisance to the comments being made, especially about putting resources right there on the front line, delivering for the very people who are paying the wages.
	In his evidence to the Select Committee on 20 July, the Health Secretary set out five aims of the White Paper, and he went through them here today. I shall review some of those in the light of the dribbles of information that we have received, and see how they stand up. The first aim was creating a patient-led NHS. Let us start with the Secretary of State's glib catch-phrase, "No decision about me without me"-

Andrew Lansley: Glib?

Rosie Cooper: Yes, glib. Where is the substance? Will it make any difference if the GP consortiums do not agree with the Secretary of State? Will those consortiums meet in private or in public? Will he listen to those patient voices? Will he be able to hear them?

Jim Shannon: Does the hon. Lady agree that when it comes to prevention and early diagnosis of diseases, the GP and what happens at the clinic and the surgery is critical? Money can be saved in the long term. Perhaps that is what the Government should be doing-making sure that money is there on the front line, in the GP surgeries and in the clinics.

Rosie Cooper: Nobody could disagree with that.
	The NHS will be one where the area and street where people live will determine whether they have access to certain drug treatment, because of the weakening of NICE and a shift back to value-based pricing, placing drug companies back in control, and a return to postcode prescribing-an NHS where people may or may not get certain operations. Already in my area, across Lancashire, primary care trusts are reviewing funding for 70 procedures, so if patients require an endoscopic procedure for their knee or back, or a hysterectomy, those may no longer be available.
	How far people travel to their hospital depends on whether they have a hospital close by that offers the treatment that they need. On 26 October at the Select Committee, various witnesses gave evidence that hospital closures will be necessary to release moneys back into the wider health service. How many patients would agree that such a state of affairs is part of a patient-led NHS? Not many, I bet.
	Improving health care outcomes was the Secretary of State's second aim. It seems highly unlikely, given that the ability to deliver improved outcomes is reliant on front-line services and the availability of the staff to deliver them. The Royal College of Nursing expects to lose 27,000 front-line jobs. That is the equivalent of losing nine Alder Hey children's hospitals. The work of the RCN suggests that under the guise of 45% management cuts, the NHS will lose health care assistants, nurses and medical staff-front-line cuts by stealth.
	All this must be set in the context of what was said to be the lowest financial settlement since the 1950s, reputed to be 0.1%-as we heard today, that is already disputed-together with massive pressure on NHS budgets from increased VAT costs- [Interruption.]-redundancy payments, budget short-falls and hospitals having tariffs frozen- [Interruption.]

Dawn Primarolo: Order. The Secretary of State does not need to shout across the Chamber. He has had his time.

Rosie Cooper: It would help if I could hear the right hon. Gentleman, but never mind.
	The difficulties are topped up with increasing demand for services, an ageing population, an increase in the number of people with complex illnesses and the rising cost of treatment. That is all very worrying.
	At the Select Committee the Secretary of State spoke about increasing autonomy and accountability in the NHS. I have raised that with him on a number of occasions and I tried to intervene today. It is a further example of the two health policies of the Administration, one mythological and the other the reality. Perpetuating the myth, the Secretary of State said at the Select Committee that
	"the conclusion that we reached was that we could achieve democratic accountability more effectively by creating a stronger strategic relationship between the general practice-led consortia and the local authority."
	We might imagine that that meant patients and elected representatives at the heart of decision-making, and that the consortiums would operate with councillors on the board, who would be able to vote, but no. Scrutiny will come from well-being boards, which means that patients and councillors will not be there offering their opinions and able to vote. Well-being boards, like the current NHS overview and scrutiny arrangements, may as well not exist because they will be nothing more than a focus group.
	I said at the Select Committee that those arrangements were nothing short of throwing snowballs at a moving truck-they would make little or no difference. The Government are giving a budget of more than £80 billion to GPs who just want to practise medicine and not get involved in the experiment.

Lisa Nandy: May I mention the issue of GPs and safeguarding, the key role that GPs play in keeping children safe, and the fact that if they are spending time commissioning services, who will fulfil that vital function?

Rosie Cooper: We need to get more GPs to do that, and I think that is what the Secretary of State is trying to say.
	The Government plan no testing or pilots, just a big bang, using consortiums as a shield to deflect criticism from them, rather as they currently use the Liberal Democrats.
	The fourth aim was promoting public health. Everybody agrees that prevention is key to easing the cost burdens further down the health pathway, so if we were serious, we would be doing more about promoting public health. Simply allocating 4% of the NHS budget and giving it to cash-strapped local authorities does not seem the best and most effective way of promoting public health. We await more detail, although that might be as difficult to follow as the Department of Health's £1 billion allocation to social care.
	That brings me to the fifth aim of the White Paper. Following the publication yesterday of "A Vision for Adult Social Care" by the Department, the foreword gives us a sense of where we are heading with the Government's policy. Under the third value, responsibility, it states:
	"Social care is not solely the responsibility of the state. Communities and wider civil society must be set free to run innovative local schemes and build local networks of support."
	I wonder whether that is code for "We've got no real money to invest. Local authorities are not going to be able to meet the demand. Oh well, you'd better get on with it yourself."
	It is no use the document quoting Frederick Seebohm from 1968, as that might not reflect the world of today. As an ideal, it is great, but not every family and every individual can offer the help and support that are required. There are incredible strains on hard-working families and individuals trying to make ends meet while struggling to provide care for ill and elderly relatives-

Dawn Primarolo: Order. Time is up.

David Tredinnick: I support the Opposition's motion in one respect: their call on the Secretary of State
	"to listen to the warnings from patients' groups, health professionals and NHS experts".
	I want to address particularly the issues affecting those in integrated health care. I speak as the chair of the integrated health care group-the old complementary medicine group-and as someone who has the honour of serving under my right hon. Friend the Member for Charnwood (Mr Dorrell) on the Health Committee. I wish to look at the regulation of herbal medicine, the possibility of complementary medicine leading to cost reductions in the health service and the choice of services.
	As my right hon. Friend the Secretary of State knows, we will have a problem next year with the implementation of the traditional herbal medicines directive, about which many colleagues have been approached by constituents. From April, practitioners will no longer be regulated under section 68 of the Health Act 2009, so my first plea to my right hon. Friend is to come up with a solution to this problem ahead of time-ahead of Christmas, I hope. Otherwise, from April, practitioners will be unable to prescribe the herbs they have been prescribing under the section 68 derogation. The best course of action is the Health Professions Council, because that is the only body-

Dawn Primarolo: Order. I should remind the hon. Gentleman that we are not discussing the directive, amendments to the directive or herbal medicine. We are discussing the reorganisation of the health service, to which he needs to direct his points to make them relevant to the motion.

David Tredinnick: Thank you, Madam Deputy Speaker. What I am talking about is relevant to cost savings, choice and the use of existing practitioners. I hope that my right hon. Friend will deal with that issue; otherwise it will cause him major problems next year. I will now move on.
	The other, related problem is that, under this arrangement, unless my right hon. Friend acts, we will lose many available products from the shelves, which will affect health service costs and what practitioners can do. Yesterday, I went to Brussels to discuss the issue as it affects health service, which we are discussing, and related cost savings. I spoke to Elena Antonescu, a Member of the European Parliament, who advised me that if the health service is to continue with traditional Chinese and Ayurvedic medicines, the Secretary of State will have to lobby Members of the European Parliament to go to the Commission to produce a report that they first proposed in 2008.

Dawn Primarolo: Order. The hon. Gentleman is pushing at the margins. We are not discussing European directives; we are talking about reorganisation of the health service in line with the White Paper. He must put his comments in that context.

David Tredinnick: I am most grateful to you, Madam Deputy Speaker, for your help. I have made my point about Europe having to be involved.
	I also want to comment on the points made by my hon. Friend the Member for Basildon and Billericay (Mr Baron) and others about cancer care. Cancer patients can be much helped by integrated health care practitioners. I could cite many different hospitals, but I shall mention just one-Royal Surrey County hospital, which is a national health care award-winning hospital. It includes St Luke's cancer centre, which offers a wide range of complementary therapies in support of the health service. I want to see such choice widened. If herbal and nutritional medicines are used, that will reduce the costs of the health service referred to in the motion. Many institutions abroad, such as Australia's National Institute of Complementary Medicine, have shown Governments the way and enabled them to restructure services and provide cost savings.
	With those remarks, I very much hope that my right hon. Friend the Secretary of State looks with care at what I have said about these benefits.

Dawn Primarolo: Order. The hon. Gentleman, who is a very experienced Member of this House, has been pretty close to not being in order. I take it that he has now resumed his seat, and I will move on to the next contribution.

Diana Johnson: I am delighted to have an opportunity to say a few words in this debate.
	Labour's investment in health care over the past 13 years has produced huge strides. When we think about the position in 1997, with long waiting lists and hospitals in desperate need of refurbishment, we realise that we have come a very long way. I am disappointed that the new coalition Government, instead of deciding to build on the very successful investment over the past 13 years, are now engaged in an ideological approach to the NHS to bring in the private sector and to destroy a lot of the very good work that has been done.
	I pay tribute to all NHS staff, clinical, non-clinical and administrative, who do their best and work very hard for patients. One of the most upsetting things I have heard since May is Government Front Benchers' denigration of our NHS managers and administrators. That is very wrong.
	My main starting point is to look at whether the coalition's proposals will improve the health of my constituents in Hull. I do not think they will. I am absolutely appalled that the Government are to spend £3 billion on reorganisation when there is such a tight financial settlement for the NHS. Their focus should be on ensuring that patient care is maintained over the next few years, not on reorganisation.
	Hull has a very good primary care trust. I pay tribute to the excellent and innovative work of Chris Long, the chief executive, and of Wendy Richardson, the jointly appointed director of public health with the local authority. As a spearhead PCT, Hull received additional money under the previous Government. It introduced projects such as the health trainers who have done so much in working with communities that have high levels of health inequality, for which different ways of working must be adopted. It has also done work on domestic violence and worked with its perpetrators.
	The reason I am such a fan of Hull PCT is that, unfortunately, we have a Liberal Democrat-controlled council that does not seem to have any focus on its responsibilities for public health. The previous Labour council introduced free healthy school meals in all the city's primary and special schools, rather than wait for an evaluation after three years of the pilot project, but the Lib Dems came in and scrapped it. The project was trying to do something about the high levels of obesity and poor performance in schools-to get to our youngsters early to ensure that they eat well. When that Lib Dem council is given the agenda for public health, I do not have much faith in it taking it seriously.
	Hon. Members will recall the introduction of the free swimming initiative in the previous Parliament, which got our young people active through swimming and engaged our councils. Of course, Lib Dem-controlled Hull city council said, no, it was not going to get involved, and at the same time it put up the costs to our youngsters of attending sports clubs in the city. I am therefore very sceptical about the proposed public health agenda being taken on by Lib Dem local authorities.

Lyn Brown: My hon. Friend will know about the health needs in Newham, where the incidence of TB is rising and the rate of HIV is very high. The people who have helped me and my constituents most in managing these health needs have been the people at the PCT, who have been very responsive to my requests and requirements. Has she found the same in Hull?

Diana Johnson: Absolutely. Although not all PCTs have operated as we would like, there is good practice throughout the country. We should focus on that and see what we can learn.
	I am concerned about the coalition Government's approach to public health, because the junk food industry seems to be helping them to make policy, as some of our national media have reported in the past few days.

Kate Green: Is my hon. Friend aware that the Government have decided to abolish the health in pregnancy grant, which would further assist pregnant mothers with healthy eating and preparing for the birth of a healthy baby?

Diana Johnson: Absolutely. My hon. Friend campaigned long and hard for families, especially low-income families, in a previous occupation. The health in pregnancy grant is going and the Sure Start grant will now be paid only for the first pregnancy, so we are starting to see what the Government really think about improving people's health, especially that of women.
	Of course, we must not forget that during the election campaign in May the Liberal Democrats made it very clear that they thought NHS funding should not be ring-fenced. The right hon. Member for Twickenham (Vince Cable) said that the NHS should not be treated as a sacred cow. Again, we see the Liberal Democrats being the more regressive part of the coalition.
	I wish now to concentrate on GP commissioning, because there are major issues on which we need to focus. Many specialist groups, particularly the muscular dystrophy group in Yorkshire, have been in touch with me to say that they are concerned that local GPs will not understand their health needs. I have talked to patients in the local hospital and other people receiving health care locally, who are anxious about their particular needs being met.
	For me, a bigger issue is the performance of GPs. PCTs have been particularly successful in holding to account GPs who do not perform as well as they should, and I am particularly concerned about who is going to hold the ring. Who will deal with GPs who do not meet the needs of their communities?
	A number of hon. Members have mentioned the bureaucracy in the new system of GP consortiums. I believe that there will be more administrators, and I say to the Secretary of State that, if we are to focus on health outcomes, bureaucrats will be needed to put together information and statistics and we will not, therefore, see the massive reduction in backroom staff that the Secretary of State expects.
	A lack of accountability at local and national level is a major problem. The new national board-the largest quango that we have ever seen-is being created, but to whom will it be accountable? It is not acceptable for the Secretary of State and his Ministers to come to the House and say, "That is for the national board", or "That is for local decision making". We need control over what happens to our NHS. As I asked in my intervention on the right hon. Member for Charnwood (Mr Dorrell), why cannot we have some pilot projects? If the change is to be so great, let us pilot it, see what happens and take a considered approach. Let us have some evidence to back up the White Paper.
	I do not believe that any of the Government's proposals will improve the health care of the people I represent. Of course we believe that clinical involvement is important, and of course doctors and other health care professionals should be involved. My hon. Friend the Member for Rochdale (Simon Danczuk) made the point that we should use the PCT structure to provide more clinical information and advice-we can have that involvement without throwing out the whole structure.
	The Government must also consider other health care professionals, such as pharmacists. There are pharmacists on the high street in my constituency who really contribute to the health care of my constituents. People such as Mr Hall on Beverley road and Cath Boury on Newland avenue do face-to-face work to encourage people to give up smoking or reduce their weight. If we want to get clinicians involved, let us get all the clinical practitioners involved.
	I finish with the "any willing provider" model in the White Paper. The Labour Government made it clear that the NHS was the provider of choice. That was exactly the right thing to do, because it recognised the important role the NHS has played over the past 60 years. It has staff with specialism and dedication, but the idea of "any willing provider" is just code for the private sector, is it not? The attitude is, "Let's just roll it out and have the private sector run our NHS". Most people in this country, particularly those who vote for the Liberal Democrats-I point to their Benches in saying this-will be shocked to know that their MPs are standing up for the private sector. It is disgraceful, and I hope very much that the White Paper will be amended to state that the Government support the NHS as the main provider of choice, rather than going down the road of the private sector and the Americanisation of the NHS.

John Baron: The Government's refresh of the cancer strategy, announced within two months of their taking office, and their commitment to the cancer drugs fund, clearly illustrate their commitment to improving cancer services in this country. As chairman of the all-party group on cancer, I very much welcome that.
	May I suggest that the Government's focus on outcomes is long overdue? Cancer survival rates in this country have been improving steadily for the past 30 years, but it remains scandalous that the UK is still floundering in the lower divisions of the international cancer league. Part of the problem is that for too long, the NHS has been focused on process-based targets. We need greater focus on outcomes to put the spotlight on just how well the NHS treats patients, not just on how quickly they are seen. That focus will be very important to patients, and particularly to cancer patients.
	Last year, our all-party group set up an inquiry, which reported at the end of the year, on cancer inequalities. The evidence clearly showed that patients who survive one year stand as much chance of reaching the five-year point as cancer patients in other countries. However, where this country lets itself down is that our figures are poor compared with other countries when it comes to the one-year survival rates figures. That suggests that the NHS is as good as, if not better than, any other health service when it comes to treating cancer once it is detected, but falls down badly in detecting the cancer in the first place. That was why the all-party group's report recommended the introduction of a one-year cancer survival rate measure, to encourage earlier diagnosis. Late diagnosis makes for poor one-year figures, hence our recommendations. I was therefore delighted that the Government picked up on that point and introduced one-year cancer survival rates as well as five-year survival rates in the White Paper.

Lyn Brown: I am following the hon. Gentleman's excellent speech with care, and I totally agree with what he has said so far, especially about early diagnosis. In poorer areas, early diagnosis does not occur so often, for myriad reasons. In his view, what is set out in the reorganisation White Paper that will make early detection of cancer easier in areas such as mine?

John Baron: The answer to the hon. Lady's question was supplied by my right hon. Friend the Secretary of State in answer to my question earlier. The one and five-year cancer survival rate figures will be published and presented, although how that will happen is in the melting pot. I very much welcome the work of the Office for National Statistics, the National Cancer Intelligence Network and the London School of Hygiene and Tropical Medicine. Whatever form the figures take, they will be in a performance table, not a league table, to ensure that all PCTs and then GP consortiums are tasked with improving performance, irrespective of how they compare with others. That will obviously include PCTs in deprived areas across the country.
	I suggest to my right hon. Friend the Secretary of State that the focus on outcomes must include patient experience measures and longer-term quality of life measures, such as whether patients are able to return to work. That, too, is very important from the point of view of cancer patients.
	As an aside, I suggest that there is a question mark about process-based targets such as waiting times in general. To return to the point made by the hon. Member for West Ham (Lyn Brown), the real problem when it comes to late diagnosis is not whether it takes one, two or four weeks for a patient to see a cancer specialist. It is how long it takes for the suspicion to be raised that cancer exists in that patient in the first place. Perhaps we should incentivise GPs to detect cancer earlier.

Kate Green: I absolutely appreciate the expertise that the hon. Gentleman brings to the debate, but I should like to ask his views on the issue of anxiety while waiting for an appointment. Whatever the physical outcomes of early treatment, there is a peace of mind issue for patients who are anxious to see their doctor as quickly as possible.

John Baron: I accept what the hon. Lady says, and I hope that the focus on outcomes will include matters such as patient experience surveys, which will incorporate that very point. It is an integral part of a patient's experience, and it should be picked up when we start focusing on outcomes.
	I return to GPs being incentivised to detect cancers earlier. In that vein, I very much support Cancer Research UK's campaign to encourage greater access for GPs to diagnostic testing. That will be terribly important when it comes to detecting cancers earlier.
	Moving on to GP commissioning of cancer services, there is no doubt in my mind that there is room for improvement in this area, and it would be naïve of Members to believe otherwise. There is often frequent confusion between the roles of strategic health authorities, cancer networks, PCTs and hospital trusts. The priorities of the cancer reform strategy are often not aligned with those of the PCTs.
	I should like to play devil's advocate and suggest to the Secretary of State that we need to tread carefully in dealing with the challenges ahead. The Secretary of State will be aware that GPs see only about eight new cancer cases a year, and that cancer is a set of 200-plus diseases with often complex care pathways. The GPs are often involved in the early and late stages of that care pathway, but the complex bit in the middle is often conducted by clinicians in hospitals.
	Challenges lie ahead. We need to ensure that the responsibilities of the NHS commissioning board, the PCTs and the GP consortiums are clearly defined to avoid fragmentation of treatment across the cancer pathway. The reforms must help and not hinder the close working relationship between primary and secondary care doctors. The role of cancer networks in supporting GP consortiums needs to be clarified before those networks are broken up and their expertise is lost.
	Furthermore, we must consider whether we need to redistribute the financial incentives to encourage more focus on the earlier and late stages of the care pathway. In other words, we must ensure that reward matches responsibility. Should a qualities and outcomes framework be realigned so that early diagnosis, survival and people dying in their place of choice are included?
	In the last minute left to me I shall mention the cancer drugs fund. I have raised the issue with the Secretary of State before. There appears to be early evidence of disparity of access. When it comes to the cancer drugs fund, access should always be clinician-led. In some regions, approaches can be made to the PCT, and in others they are made to the cancer network, which, in turn, has access to the fund. Elsewhere, GPs are forming panels. May I suggest that best practice from the interim drugs fund is applied uniformly before the main drugs fund kicks off next spring? We do not want to add to cancer inequalities when it comes to access to treatment and drugs.
	In the past, rarer cancers have had a very raw deal. I know that the Secretary of State is conscious of that and will ensure that those who suffer from rarer cancers will be treated much more fairly than in the past.
	There is not time for the Secretary of State to answer all my questions now, but I hope that he will address them when he speaks at the Britain Against Cancer conference on 14 December, and I look forward to hearing what he has to say.
	In short, the refocusing on outcomes is the greatest innovation and benefit to patients since the NHS began. However, that must not be undermined by the problems over GP commissioning.

Yasmin Qureshi: Thank you, Madam Deputy Speaker, for giving me the opportunity to speak in this debate. I want to take up a few of the points made by the Secretary of State. First, he talked as if the previous Labour Government had done nothing for the NHS and had shown no concern about how people were treated. It is worth reminding the House what Labour inherited in 1997 after a number of years of Conservative mismanagement. We used to have waiting lists of more than two years. Now, waiting lists are down to less than six months. A record number of nurses, doctors and porters have come into the hospital system. Many hospitals have been built and many others have been refurbished. Therefore, we will not listen to the Government telling us that we did nothing or that we did not take care of the NHS. We spent more than £80 billion on the NHS, which benefited many people. The Government state that they will protect the NHS and will not reduce the funding. That is just not correct. They talk about billions of pounds going into the NHS, but the money will actually go to the social care fund, which does not directly benefit people in hospitals. In real terms, there will be a 17.5% cut over four years. There is a decrease in the budget and services will be affected.

Lyn Brown: My hon. Friend must have noticed the chuntering taking place on the Government Front Bench. The same happened during the speeches of a number of other Opposition Members. Does she not think that that is really poor form, especially when the Secretary of State did not seem able to take interventions when it was his turn?

Dawn Primarolo: Order. That is a matter for me to control. The hon. Lady will continue with her speech. I am sure that all Members of this House, including those on both Front Benches, will behave appropriately in this debate.

Yasmin Qureshi: We are told by the Government that the reorganisation is not ideologically driven, but is somehow a way of maximising efficiency and making the systems better. At a time when we are being told that there is not enough money, commentators and experts are saying that this reorganisation will cost at least £3 billion. We are not talking about a small amount of money; we are talking about £3 billion.

Lisa Nandy: In my constituency of Wigan, despite the extreme and visible progress that we have made in the past 13 years of Labour Government, there are still significant health inequalities. In fact 129 per 100,000 people in my constituency die of coronary heart disease, compared to 90 nationally. I know that my hon. Friend shares my concerns, but does she agree that, at a time when we should be addressing those health inequalities and continuing to invest in the NHS, it is an absolute scandal that we are spending the amount of money that she suggests?

Yasmin Qureshi: I entirely agree with my hon. Friend. She and I have almost adjoining constituencies, and many of the issues and problems of her constituents are very similar to those in my area. When we were in power, £345 million was set aside for disabled children, for respite and all-night breaks. All of those children will now suffer because the White Paper makes no mention of funding for disabled children after March 2011. Yet, we have £3 billion to pay for reorganisation. On 2 November 2009, the Prime Minister, then Leader of the Opposition, told the Royal College of Pathologists that under the Conservatives, there would be no more restructuring of the NHS.
	On 20 May, the coalition Government said:
	"We will stop the top-down reorganisations of the NHS that got in the way of patient care."
	What are they doing? They are carrying out exactly that reorganisation. If the Government want to make some real improvements to the NHS, the principle of "no decision about me without me" should be considered. The Health Secretary should reconsider the NHS reorganisation and try to think of a better way to use that money for patients.

Jonathan Reynolds: My hon. Friend says that the reorganisation is ideologically driven. Is not it the case that when one intends to spend up to £3 billion, one needs an evidence base and proof that that spending-whatever it is on-will be money well spent? As my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) said, there have been no trial programmes or pathfinders. The money could be spent without a shred of evidence that it will make one bit of difference.

Yasmin Qureshi: I agree. I was about to discuss the impact of the reforms, with GP consortiums replacing PCTs. We know that there will be huge differences in the arrangements for health care in different areas. With the formation of up to 500 GP consortiums, all free to set their own priorities, a highly visible two-tier service will develop. Patients will be forced to move GPs or be reallocated to another area to get the care that they need.
	The financial success of each consortium will also affect the service that patients receive. It will influence of the type of care provided and how long it lasts. Some patients who need hospital treatment will inevitably be told by their GP, "Sorry, you'll have to wait until next year." Evidence has shown that making providers compete for patients and providing more choice to patients has done little to improve quality. Most people who are offered a choice of hospitals opt for their local provider. Choice may be important, but for patients, it comes below the quality, speed and accessibility of care.
	The proposals do not make it clear whether the patients of the commissioning GP do the choosing. However, the GPs' new contract will have a powerful incentive to hit commissioning targets. How, therefore, do patients know whether they are being prescribed the best or just the cheapest treatment going?
	Again, there is no evidence to show that the restructuring would reduce the bureaucratic load. Hospitals alone will have at least three times the number of commissioners with whom to communicate and contract. Five hundred GP consortiums, each with its own set-up and administrative costs, will replace the current 150 PCTs. Huge differences in the arrangements for health care will emerge between areas. A postcode lottery will develop.

Yvonne Fovargue: Does my hon. Friend agree that the description of a consortium of GPs-a loose affinity of people with whom they get on rather than a geographical boundary-and the loss of co-terminosity will affect patients? Indeed, it will not simply be a postcode lottery, but, across the board, a matter of whom a patient is registered with.

Yasmin Qureshi: I thank my hon. Friend for that intervention. Some years ago, when that sort of process was introduced in the legal system, with solicitors able to apply for franchises, the big firms benefited and the smaller, local firms went bust. A similar thing will happen. Some GPs, who run small surgeries in the heart of a community, will not be able to form consortiums. What happens to them? Does it mean that people in parts of Kearsley in my constituency will have to travel seven miles to go to a big GP consortium rather than being able to walk down the street and speak to their GPs, as they currently do?
	The reform means that private patients will have a chance to pay for faster care in the NHS. Now that the restriction on the income that can be made from private patients is being lifted, cash-strapped hospitals will find it difficult to resist that income stream. Patients could routinely be offered that route to faster treatment. Thus wealthier people can queue jump, while NHS patients will linger on a lengthening waiting list.
	I know that the Secretary of State-

Dawn Primarolo: Order. I am sorry, but time is up.

Steve Brine: I shall be brief as I know that many hon. Members wish to speak. I am pleased to speak in the debate as someone who is about to see rather a lot of our national health service. My wife and I are due literally any day now-some may say tomorrow-to have our second child at the Royal Hampshire county hospital in Winchester, so all, including my Whips, will forgive me if I miss the Adjournment debate tonight.
	Perhaps I am a little biased, but the Royal Hampshire in my constituency is in many ways the sort of institution that I see as the cornerstone of our national health service. It is a classic district general hospital, with a full service, and maternity and A and E departments at its heart. Elderly care services are first rate and infection rates are among the lowest in the NHS. We have a neonatal baby care unit, for which many similar sized institutions would give their right arm, and a bustling out-patients unit. Of course, the hospital would like to do more, but it sits at the heart of the community in Winchester and the surrounding areas because it is continually strengthened by the fact that the people who work there-the nurses, the midwives, the consultants and the cleaners-live in and around the city of Winchester. Of course, the NHS is more than its physical hospital buildings, but I view the Government's equity and excellence White Paper in the context of institutions such as the Royal Hampshire and the locally connected NHS services that cluster around it.
	My local NHS trust will undergo many changes in the coming years as it prepares, with its partners, to make the gear change to foundation status. That is absolutely right in my view to liberate our NHS. As I have often said to my trust and to the people I represent, I am not hung up on the name at the top of the wage slip for individual employees of the NHS in Winchester or anywhere else; I am merely concerned about the services that the NHS in Winchester offers the people I represent. I suspect that no hon. Member would disagree with that.
	Equally, I am concerned about protecting the services in the financial context in which we find ourselves and the enormous national debts under which we labour. I am proud that my right hon. Friend the Prime Minister put the NHS at the heart of his programme for government. He must have been watching closely because I did the same in Winchester. I am especially proud to be elected as a new member of the new Government, who made the political choice-it is a choice; we did not have to do it-to protect health spending in the recently announced spending round. I know that Labour Members do not believe that and that at every turn they will try to rubbish it, as we have seen from part of the motion's wording today. I guess that part of me, were I in their position, would do the same. It must really rankle. There is a new coalition Government, led by a Conservative Prime Minister, who are pledged to protect the NHS and put it at their heart. I am proud of that.

Jonathan Reynolds: Does the hon. Gentleman think that the terrible cuts that our local authorities will face in adult social care and other core services will absorb the ring-fenced money for health simply because they will not be able to provide in future the sort of services that they currently provide?

Steve Brine: No, there is absolutely no reason for them to do that. My right hon. Friend the Secretary of State for Communities and Local Government will make an announcement on council funding, but the Secretary of State for Health has already announced in the comprehensive spending review that the Government have allocated moneys for social care.
	I know that the Labour party will try to rubbish our proposals, and that is their choice. My point is this: the people I represent do not care much about how the NHS is structured, but they care a great deal about ensuring that their NHS is there when they need it. They pays their money, and they expect the NHS to be there when they need it, free at the point of use. That is the cornerstone of what we are proposing.
	I am very happy to defend outcome-focused, GP-led commissioning for my constituents. Every health care system in the world worthy of the name has the GP-patient relationship at its heart, and our proposals for GP consortiums seek to strengthen that for the sake of all the people we represent. Why on earth would we propose anything different? GP consortiums are an enormous opportunity for the NHS, and the perfect way to further the "no decision about me without me" agenda that is so important. I do not think that that is glib, as an Opposition Member said earlier. It is about rejecting the "Like it or lump it-this is the service you're going to get" view that we have heard for far too long in our health service.

Rosie Cooper: I would like to state on the record that the expression is glib when it is uttered by a Secretary of State who does not back it up, who does not place patients at the centre, who will not have patients or their elected representatives serving on consortiums and who makes grand statements that are baseless and meaningless.

Steve Brine: I am sorry I gave way; I expected something else. I do not think for one minute that it is glib. We are not suggesting that every single patient will be involved in every single element of their care, but how could anybody disagree with "no decision about me without me"?
	GP consortiums are an opportunity for the health service finally to realise one of its original aims-the sophisticated management and prevention of illness through the intelligent use of the patient list. That is still a largely untapped resource in our national health service.
	GPs I speak to are up for their new role in commissioning for their patients. Of course they have questions-it would be strange if they did not-but they are not calling, as the Opposition's motion is, for us to ditch our plans because things have got difficult and they have a fear of change. The Opposition cannot have it both ways. They support our plans for more GP involvement in patient care, but call plans for GP consortiums inefficient and secretive.
	I see my job as a Member of Parliament as being an important link in helping GPs to answer some of those questions about consortiums that are coming down the line. I know that my right hon. Friend the Secretary of State has met groups of GPs in other areas of the country, and I ask him today to check his inbox because an invitation from me is coming his way.
	As we know, following the establishment of GP consortiums, primary care trusts will no longer have NHS commissioning functions. It would be nonsense to create GP consortiums and keep two other tiers of management commissioning alongside them. Investment in the NHS has not been matched by reform. Yes, we will protect NHS investment, but our reform agenda builds on the best of the reform process over the previous 20 years. An Opposition Member said that we reject everything that went on under the previous Government, but of course we do not. We have made that very clear. These proposals build on Labour Government measures such as practice-based commissioning and NHS foundation trusts, and rightly so.
	I sometimes hear it said-I heard it put to my right hon. Friend the Secretary of State yesterday morning on the "Today" programme-that the Government's health policy was a bit of a surprise to everybody. I do not know why that would be. I mentioned earlier that the Health Secretary visited the Royal Hampshire county hospital. That was in May 2008, and he discussed the policy with people there then. He will remember the visit.

Jonathan Reynolds: Will the hon. Gentleman give way?

Steve Brine: No, I want to finish my remarks. My right hon. Friend will remember discussing with those professionals his ideas, which were published. He referred to those ideas in 2006, and they eventually made it through to our manifesto and the coalition agreement. They certainly should not have been a surprise to anyone who was watching.
	I know that my colleagues will all be speaking to their PCTs and strategic health authorities, as am I. I have had a positive dialogue with NHS Hampshire in the months since I was elected, and I pay tribute to its chief executive who takes the responsible view that her job is to ensure that the NHS in Hampshire has what she calls a safe landing and a smooth transition to GP consortiums.
	I turn now to public health and local accountability. As we know, a key part of the coalition plans for health involve the transfer of public health to local authorities, who will employ a director of public health. I know that these directors will be responsible for health improvement using a ring-fenced public health budget according to the needs of the local population, and I warmly welcome the move. However, I sound a note of caution about local authorities leading in public health. I urge Ministers, perhaps through partnership working with the Local Government Association, to ensure that councillors are taken into every single step of the process and that sufficient training is given. I know that the cult of the amateur has held sway in many parts of our public service, but this is one area in which we need to support locally elected representatives as much as possible.
	As co-chair of the all-party group on breast cancer, it would be remiss of me not to mention the very real concerns that we have about access to specialist nurses in the NHS, which traditionally have been an easy target for cuts. That must not happen under the new arrangements. It would be a false economy for any GP consortium to do that.
	The coalition plans for health reform are not a gamble; nor are they ideological. They are about recognising that we live in the shadow of appalling national debts, and we remember where they came from. Protecting the front line, pushing power down to the local level and dealing with the national debt crisis are what "Equity and excellence" is all about, and that is why I will not be supporting the motion.

Kate Green: Let me begin by wishing the hon. Member for Winchester (Mr Brine) and his partner well for the pending new arrival. I am sure that they will receive an excellent service in their local NHS hospital, and that the whole House wishes them the very best.
	I should like to use this opportunity to raise a few of the concerns that have been brought to my attention by people in my constituency. Many do not fully understand how the new proposals will work to deliver the outcomes we hope for, and I hope that the Minister can answer for them this afternoon. Essentially, people are anxious that where they live and who they are will begin to determine the level and quality of their care.
	I am sure we all agree that consistency and guarantees of standards must be an integral part of the operation model that the Government seek to introduce. That is especially important in relation to health outcomes for the poorest and most vulnerable. There is a high level of health inequalities in my constituency. The people who live in the poorest wards suffer much worse health outcomes than those in the better-off wards in the south of the borough of Trafford. The local authority was quite slow to recognise that, so how will health inequalities receive strategic attention in the proposed new structures?
	What will be the role of the public health director, who will be placed within the local authority? I am keen to know how that public health role in the local authority will devolve and relate to those at the sharp end in all health settings-those who provide front-line care. I hope that the Minister can fully explain that in his winding-up speech so that my constituents can be clear about it.
	My constituents and I are concerned about how the wider drivers of health inequalities-income, education, employment and so on-will be addressed in the new structure, particularly when so many national policies seem to be taking us in the opposite direction, as my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) pointed out earlier.

Lisa Nandy: Does my hon. Friend agree that as well as the vast inequalities in life expectancy, the lingering issue of care for those who live longer and longer with chronic illnesses needs to be addressed? Those people are suffering now. Does she agree that it is an absolute disgrace that the Government have decided to tinker with the structures rather than put in urgent investment to help those people, including people in my constituency of Wigan?

Kate Green: Labour Members want to know whether the money spent on the restructuring of front-line care in our communities is the best use of that money. As the Health Secretary himself pointed out, we continue to have poor health outcomes and standards compared with our European neighbours, so why does it make sense to put more money into reorganisation and less directly into front-line care? I look forward to hearing what the Minister says about that.
	The second issue that I want to address involves patient voice. That, too, has been raised in my constituency. A particular concern of mine is to ensure that the poorest and most vulnerable are heard. I am concerned about the lack of voice of those who do not have the sharp elbows and the articulacy to speak up for themselves to secure the best for themselves and their families. We know that that is the fate of many in our poorer communities, and especially of those with mental health problems.
	I have been told a number of times in my constituency, including by GPs, that GPs are not particularly expert in, or equipped to deal with, mental health needs. How will those patients' needs be identified, recognised and responded to in the new structure? What help will be available to enable patients to articulate such needs? There is uncertainty in my constituency on the future structure. How will patient voice, choice and opinion feed in to the new model?
	The Trafford patient LINk-local involvement network-service is uncertain about its future role and status. I very much hope that Ministers will be able to give us more information about how we will get a clear opportunity for advocacy, so that every patient's voice can be properly heard, and for proper support for patients who are perhaps less able to articulate their needs and secure services for themselves.
	I am concerned also because I know-not just from my constituency, but from my long experience of supporting and working with vulnerable families-that different values pertain among different doctors and practitioners. I am particularly concerned, for example, for the young woman who may present herself to a GP who does not feel it appropriate to offer her advice on contraception or abortion. How can those minimum standards be protected, so that everybody-wherever they live, whoever their doctor is and whatever the structure is-knows that they will be guaranteed the care that they need.
	Thirdly, I would like to raise with Ministers the issues that have been raised with me by health practitioners and professionals-and which have been highlighted in this afternoon's debate-relating to GPs' ability and willingness to take on the management aspects of their commissioning role. Many GPs have said to me-perhaps the Minister will be able to reassure them this afternoon-that what they see tanking towards them is a heavy burden of management, albeit without the additional resource with which to manage it. Many GPs have said to me that they have not really had the training-they lack the expertise-to be health managers as well as good-quality health practitioners and providers of front-line health care. I am interested to know whether Ministers have plans for training GPs and developing those skills and abilities in GP practices, or whether, as many of us on the Opposition Benches fear, the proposal will in fact be used as an opportunity to privatise that management function. If that is the case-this is not an ideological point, but an efficiency point-I shall be keen to know what financial model Ministers expect to operate if a substantial amount or even a proportion of the money that would otherwise be held in GP practices will go to fund the profits of private providers.
	Those are the issues being raised with me in my constituency. They are issues that I am afraid I do not feel equipped to answer, because I do not fully understand how the new structures will work well in practice and, in particular, how they will work well for the poorest.
	In concluding, I would like to highlight a point that has been made by a number of my hon. Friends this afternoon. The injection of extra uncertainty and disruption into our national health service at this time is further-and considerably-stretching our capacity to deliver excellent front-line care. I would urge Ministers to listen to the many GPs who have said to me-and who I am sure are saying to them-that what is proposed represents an element of change and disruption that they cannot yet see the benefits of. What they can see is that there is considerable uncertainty in the way that they are now working. There is certainly concern in my primary care trust. I hope that Ministers can offer some reassurance on that point, because at the moment there is considerable instability, and that cannot be good for any patient outcomes.

Diane Abbott: This is a period of great challenge for the national health service, and it would be whoever was in government. However, Government Members accused us of not having a care for staff and patients. In fact, it is precisely because we are concerned about staff and patients that we are using this debate to point to all that is problematic-and potentially even disastrous-about the Secretary of State's proposed NHS reorganisation.
	In exploring the gap between what those in government said while in opposition and what they are saying now, we can do no better than refer to a speech that the present Prime Minister gave to the King's Fund in 2006, in which he set out the five key components of his approach to the NHS-components that, to my knowledge, he has not altered. His first component was that he wanted to guarantee the NHS the money that it needs. Who believes that now? Certainly not the Institute for Fiscal Studies, which has noted that not since the 1950s-from April 1951 to March 1956, to be precise-has there been such a small increase in NHS funding. And not the chief executive of the Royal College of Nursing, who said:
	"A huge range of services and jobs are earmarked for cuts against this urban myth that the NHS is being protected. The evidence is quite clear...this is simply not the case".
	Hon. Members, who, as the weeks turn to months, will see the cuts in their own constituencies, will not believe it either.
	My hon. Friend the Member for Sheffield Central (Paul Blomfield) talked about what is happening to children's hospitals. What has not been factored in is the cost of reorganisation, which experts have said will be £3 billion. Ministers have said that their estimate is £1.7 billion, but when asked about the number of redundancies they cannot answer. We know that the cost-

John Baron: Will the hon. Lady give way?

Diane Abbott: No, I must get on.
	The cost of redundancies, when they are factored in, will be hundreds of thousands of pounds. We believe that the figure of £1.7 billion will be overshot, and bring greater financial pressure on the NHS.
	The second point that the Prime Minister made in 2006 was that he wanted to end the damage caused by pointless and disruptive reorganisation of the NHS. He said:
	"We will not mess around with existing local and regional structures".
	So the Secretary of State's big idea for the NHS was a pointless and disruptive reorganisation.
	What do the people who work in the NHS think about that? The Royal College of General Practitioners says:
	"our members are not convinced that the scale of the changes proposed is justifiable, especially in the context of cost reductions".
	The British Medical Association
	"questions whether a less disruptive, more cost-effective process could have achieved the aims of reducing bureaucracy".
	The Royal College of Midwives says that it is
	"very disappointed that despite pre-election promises to end...top-down reorganisation...the White Paper focuses far more on structures than it does on care delivery."
	The reorganisation is high-cost, high-risk and contrary to everything that was said by those who are now Ministers in the run-up to the election. They have accused us of being confused and incoherent, but it is their reorganisation that is confused and incoherent. Every professional body echoes that thought.
	The Prime Minister said that he wanted to
	"work with the grain of the Government's reforms...So we will go further in increasing the power and independence of GPs and PCTs".
	He has gone so far that he has left GPs behind, and only one in four believe that the reorganisation will improve patient care. As for PCTs, contrary to the Government's promises when in Opposition, they have abolished them.
	What was the Prime Minister's fourth point about his main driving aims for the NHS? He said that he wanted to
	"take the politics out of the management of the NHS".
	There could not be a more political reorganisation. It is driven by ideology and a belief in free market ideology. As the chair of the BMA, Hamish Meldrum, said,
	"If the Government is truly committed to reducing waste and inefficiency, their proposals for NHS reform should focus less on competition and more on a co-operative approach on delivering health care."
	Finally in his 2006 speech the Prime Minister said that his main commitment on the NHS was
	"fair funding to the NHS...We will end political meddling...removing the scope for fiddling".
	We will see how much the scope for fiddling is removed when money is moved from the NHS budget to local authorities for social care.
	My hon. Friends the Members for West Lancashire (Rosie Cooper), for Kingston upon Hull North (Diana Johnson) and for Bolton South East (Yasmin Qureshi) all expanded on what is problematic about the reorganisation. The Secretary of State began by posing as the friend of patients and those who work in the NHS. I will not take lectures from him on that. My mother came to this country as a pupil nurse from Jamaica in the 1950s. She was part of that generation of West Indian women who helped to build the national health service. Government Members cannot talk to us about the people who work in the NHS. As for patients, are Ministers listening to the patient groups-people who represent children, people who represent the elderly, and people who represent those with mental health problems-about their concern about what the reorganisation will mean for them?
	This reorganisation is ill thought out and, at a time of tremendous financial stress in the national health service, ill timed. We believe that Government Members have been lulled into a false sense of security about what is to come. They believe that although students might be marching and the Church might be in uproar, the NHS is safe. I put it to them that, as the weeks turn to months and we move through the winter, and as we begin to see winter bed pressures, the consequences of this ill-thought-out, unnecessary, top-down reorganisation will reverberate not only in this Chamber but in the surgeries of Government Members and of all Members of this House. I am proud to support the motion.

Paul Burstow: This has been a revealing debate. Labour has come to the House today to make the case for the status quo-the case for standing still. Labour is here defending a failed status quo. We have heard Labour Members presenting to the House a number of extraordinary claims and grotesque caricatures of the Government's plans. They want to defend a failed status quo in which the NHS has been spending at European levels but has been so tied up in red tape that it has not delivered European levels of quality health care.
	For 13 years, Labour tested to destruction the idea that the NHS was best run from Whitehall. The record speaks for itself. My hon. Friend the Member for Basildon and Billericay (Mr Baron) talked about cancer survival rates, and it is nothing short of a scandal that cancer survival rates in this country lag so far behind the best in Europe. If the status quo is right, as Labour Members seem to be arguing, why are a staggering 23% of cancer patients diagnosed only when they turn up as emergencies? Why is that an acceptable outcome?

John Healey: The hon. Gentleman is right, of course; there is still more to do to improve health and to improve the NHS, but can I just check something? Did I hear him right? Did he say that the NHS had failed?

Paul Burstow: No, I said that the Opposition had failed and that they were defending a failed status quo. Let me give the House an example of a failed status quo. If the NHS were performing at the level of the best in Europe, 10,000 more lives could be saved every year. This is what our focus on outcomes is all about. It is what patient-reported outcomes are all about, too.
	We all agree that elderly patients should be treated with dignity and compassion, yet for far too many, that is not what happens in practice. Just last week, a report on patient deaths found that 61% of older people received "inadequate" care in their final days. After 13 years of a Labour Government, the NHS is in the bottom third in Europe in dealing with dementia-way behind Ireland, Spain and Portugal.

Jeremy Lefroy: As the Minister will know, the independent public inquiry into Stafford hospital is taking place in my constituency at the moment, and the matters that he has just mentioned are highly relevant to that. Will he give the House an undertaking that the evidence given to that inquiry will inform the debate on the forthcoming Bill?

Paul Burstow: We will, of course, follow the inquiry closely and ensure that we learn lessons from it. We would not have set up the inquiry if we did not intend to learn lessons.
	Labour's legacy is a demoralised and disempowered work force. Reforms have been half implemented, and billions of pounds have been wasted on a flawed NHS IT programme. This Government are clear that the NHS can be so much better than it is today-spending better and doing better both for patients and for the taxpayer. It is this Government's purpose to liberate the NHS so that it can deliver health care that is among the best in the world, to learn the lessons of Labour's top-down target-driven approach to health care, to reverse the obsessive focus on process that has stifled innovation and created dependency in the system, and to move away once and for all from a culture that measures success by ticking boxes, hitting the target but missing the point.
	Labour talked about reforming the NHS and making it more patient centred, but its reforms were half-hearted, lacking coherence and a clear purpose. Reforms such as the introduction of foundation trusts, practice-based commissioning groups and patient choice, which promised so much, did not deliver under Labour.

Frank Dobson: If the hon. Gentleman is genuinely committed to getting away from top-down impositions, will he now formally abandon the top-down proposal to take £16 million away from the Great Ormond Street hospital for sick children?

Paul Burstow: I am grateful to the right hon. Gentleman for raising that issue, as I was coming on to deal with the comments of the hon. Member for Sheffield Central (Paul Blomfield). We are all here to say, rightly, that we want the best from our NHS-dedication from our staff of professionals and creativity from front-line staff. Both the right hon. Member for Holborn and St Pancras (Frank Dobson) and the hon. Member for Sheffield Central talked about that, but I remind the right hon. Gentleman that the review of top-up tariffs started under Labour. [Hon. Members: "What?"] Yes, it was in the NHS operating framework under Labour. We will complete that review and we are engaged constructively with the foundation trusts, but I think the right hon. Gentleman should have a conversation with his own Front-Bench team before he attacks the Government Front-Bench team.
	Our proposals build on reforms such as practice-based commissioning, patient choice, foundation trusts, tariffs and social enterprise, and they hold true to the founding principles of the NHS-that it is free at the point of delivery, and not based on ability to pay.
	Freeing front-line staff from the tyranny of process targets is another issue. The hon. Member for Winchester (Mr Brine) was right to talk about the need to build on the knowledge of general practices and help them to shape services to fit local need and deliver quality outcomes.
	The hon. Member for Stretford and Urmston (Kate Green) talked about health inequalities and how they had widened in her constituency under Labour. That is why the Government are forging new relationships between the NHS and local government, making common cause on public health so that we can see it not only as a matter of medical health but as part of a far wider attack on the determinants of ill health in the first place. That makes local government entirely the right place to start.
	We must ensure that collaboration takes place. The right hon. Member for Charnwood (Mr Dorrell) talked about collaboration between health and social care becoming the norm rather than the exception, as it is today. We need to increase local accountability for health care decision making. Yes, we also need to empower patients and provide more choice and more control. Through HealthWatch, a champion for patients and service users, we should make sure that the seldom heard, too, are heard in decision making.

Andrew George: My hon. Friend rightly makes much of the need to stop the top-down reorganisations of the past and to emphasise the importance of having patient-centred structures. In that light, if a local area preferred to graft in clinical engagement in the management of the existing PCT and greater patient involvement in the structure, would he accept that as an alternative to the sort of top-down reorganisation that the Government currently propose?

Paul Burstow: It will be very much up to the consortiums to decide how to configure their governance. What we have said is that this is about the devolution of power. My hon. Friend was not against the devolution of power to the devolved Administrations in Scotland and Wales, yet this is about the same thing-shifting power away from this Front Bench and Whitehall and putting it back into the hands of patients and clinicians. Those clinicians will be engaged in commissioning, as we need them to be.
	Much has been made of accountability. Under Labour, the NHS lacked it. The hon. Member for Kingston upon Hull North (Diana Johnson) really should reflect more on what was done under Labour, because there was a huge democratic deficit. We will have greater transparency and, through our new council health and well-being boards, genuine democratic accountability.
	In the Labour motion before us today, it is wrongly claimed that the NHS has not been protected and that promises have been broken. The hon. Member for Hackney North and Stoke Newington (Ms Abbott) referred to the 1950s, but I would refer her to the 1970s, when Labour was busily cutting back-

Clive Efford: Will the Minister give way?

Paul Burstow: No. The hon. Gentleman arrived very late and was not in his place for much of the debate.
	We heard a breathtaking attack from Labour Members who argued against ring- fencing. Indeed, just a few weeks ago, we heard the right hon. Member for Leigh (Andy Burnham) saying:
	"It is irresponsible to increase NHS spending in real terms within the overall financial envelope".
	That was, and is, Labour's view-cuts to the NHS. That is not the coalition's view. That is why the NHS will get real-terms growth. Yes, it is a tough settlement; yes, there needs to be scope for increased productivity; and yes, management costs in the system need to be reduced. The Government, however, are determined to ensure that we reform the national health service, deliver the clinical engagement and deliver the change that will make the service better for our public. I urge the House to reject the motion.

Question put .
	 The House divided: Ayes 239, Noes 317.

Question accordingly negatived.

Funding and Schools Reform

Lindsay Hoyle: The time limit on speeches by Back Benchers will be seven minutes in this debate.

Andy Burnham: I beg to move,
	That this House believes that the Government is pursuing a reform agenda in education that represents an ideological gamble with successful services and has failed to honour the pledges made to deliver a pupil premium on top of a protected schools budget, and to deliver protected schools funding per pupil; is concerned that schools in deprived areas will lose out from the new funding mechanism; notes the unprecedented cuts of 60 per cent. to the schools capital budget, and is deeply concerned at the impact this will have on children, families and communities; supports empowerment of parents and their involvement in school planning but is concerned over a lack of accountability in the setting up of new schools under Government plans; is further concerned that this model will not represent efficient use of public resources in a time of austerity; disputes Government claims that these reforms are a continuation of Labour's successful reform agenda; and calls on the Government to work with families, teachers and communities to deliver improved standards of learning and teaching in all local schools.
	We have just heard how the Government are preparing to take a huge gamble with our national health service, but the same is true in schools. In health and education we see the same emerging pattern in public service reform: a free market experiment brought in at breakneck speed with scant supporting evidence at a time of financial stress, and a real risk of good services being destabilised. There is a drive to atomise services and to unpick the fabric that holds together a successful NHS and the schools system in England. We can say what we like about the Department of Health, but at least it publishes a White Paper before rushing to reform. In education the ideological zeal is not constrained by the established processes of government.
	Until recently, the Secretary of State has enjoyed a licence and latitude that other Ministers can only dream of: a big contract given to a former adviser without the troublesome requirement of a proper tendering process; a controversial education Bill rammed through Parliament in 62 days using procedures normally reserved for counter-terrorism; school building projects chopped in a casual and carefree manner, with inaccurate lists published day after day; and the services of experts who have given a decade of distinguished service to the cause of school sport dispensed with without even the courtesy of a meeting. Such things might be acceptable in the world of newspapers, but that is no way to run a Government Department.
	Today, we are glad-I see that the Secretary of State is delighted, too-to give the House the opportunity to hold the Secretary of State and his Ministers to account. He has rushed into reform without listening to parents or to students and teachers and he needs to pause for breath and to take stock. First, I shall deal with the broken promises and the idea that schools are protected. Then, I shall challenge the Secretary of State's overall direction of travel, which I believe amounts to a dismantling of state education in England as we have known it.
	So, let us start with where it all started to go wrong for the Secretary of State: Building Schools for the Future.

Graham Stuart: The right hon. Gentleman is obviously going to explain why he thinks that the reforms proposed by the coalition Government are incorrect, but is he no longer one of the reformers on his Benches? If he is still a reformer, will he say, however briefly-I know that he quite rightly wants to focus on the Government-how he would seek to reform and improve an education system that lets down too many children?

Andy Burnham: As the hon. Gentleman sees more of his Government, he will perhaps come to understand the difference between real reform and reckless reform. Indeed, the House has just been hearing about the achievements of a reformed national health service under my watch and I can tell him that I am very proud of them.
	Let me start with Building Schools for the Future and the charge that I lay at the Secretary of State's door. He has got into a mess and the allocation of capital is no longer driven by educational need but by ideology. Building Schools for the Future was a needs-led approach to the allocation of capital. Instead, he wanted to use capital as bait to lure schools into his new structural models, but then came the spending review.

Neil Carmichael: Why were fewer than 100 schools rebuilt under Building Schools for the Future under the last Labour Government?

Andy Burnham: I do not know whether the hon. Gentleman has ever been to any of those schools, but if he has seen the transformation in those communities and the messages that the schools send to children in areas that have, frankly, been let down for decades, I am surprised that he rises to his feet to say that that investment is not worth making. Let us talk about his Government and the spending review arrangements that his Secretary of State has recently secured: minus 60%. Let us just think about that figure for a moment.
	Just after the spending review, the  Financial Times reported senior Whitehall figures chiding the Secretary of State for
	"folding too early in negotiations over capital"
	spending. The only shock for me on reading that was to learn that he had been negotiating at all. We know that he is courteous, and we like that about him, but minus 60%? I can almost hear him now, politely inviting George and Danny to fill their boots. Is 60% enough? Do they want more? I doubt that the Secretary of State has played much poker in his life-although he has his poker face on now-but, as with sport in schools, it gives a person certain life skills and I recommend it to him.
	The average capital reduction across Whitehall was 30%. I would think that everyone in education could live with that. But double the punishment? How exactly does that minus 60% reduction meet the Secretary of State's "schools protected" claim?

Dave Watts: Is my right hon. Friend surprised at the Government's announcements, given the fact that the previous Tory Government spent nothing on schools? There are those of us who can remember tumbling buildings that leaked and needed the massive repairs that were put in by the Labour Government.

Andy Burnham: In the 1980s, I had the misfortune to go to a comprehensive school in my hon. Friend's constituency-a Merseyside comprehensive. It was not a great deal of fun. School sport had dried up and the buildings were appalling. It fills me with dread that my children will go to secondary school under a Tory Government. We on the Opposition Benches will campaign to ensure that another generation is not failed as others were.

Barry Sheerman: I am sure my right hon. Friend will not let this occasion pass without putting right the gross calumny against our Building Schools for the Future policy. It was not a school-building policy; it was a policy to let every local authority in our land have a vision of the transformation of education right across their community. That is what the Government are killing and that is why it is important to oppose them.

Andy Burnham: My hon. Friend is right. It was a new approach and we must give credit to my right hon. Friend the Member for South Shields (David Miliband), who said when he was a schools Minister, "Let's do it differently-let's not give out capital in a piecemeal fashion." My hon. Friend the Member for Liverpool, West Derby (Stephen Twigg) is nodding because he was in the Department at the time. Our approach was to go to the places where aspirations were lowest and young people did not have a great expectation of what life might give them, and build the best possible learning environment. That is why we should not listen to the nonsense that is spoken from the Government Benches. Building Schools for the Future has transformed many communities. It could have done more if the Government had stuck by its needs-led approach to capital allocation.
	The sad thing about the Secretary of State's negotiating failure is that it has direct and unpleasant consequences for schools and councils. Within hours of the Chancellor's sitting down, there were panicked phone calls asking for 40% cuts to projects that only weeks before had been approved by the Secretary of State as unaffected. Why? Because what was left of his capital budget was needed to push towards his pet projects-or as we should now more accurately say, his pet shop projects. The losers, yet again, are schools in some of the most deprived parts of the country: Sandwell, Birmingham, Salford, Leicester and Nottingham.

John Healey: And Rotherham.

Andy Burnham: I could go on. There are more.
	Last week, I went to the Wodensborough technology college in Sandwell-a great school, battling against the odds. The Secretary of State is nodding, but he has not been to Sandwell. Since the summer, he has promised many times that he will go there, so I hope he is nodding because he will actually do so. When he was at his conference in Birmingham he was not far away. We hope he will go to Sandwell.
	The college has been thrown into limbo by the 40% demand that is now being made of local authorities. After all the chaos to Building Schools for the Future that the Secretary of State caused in such authorities back in the summer, it is barely believable that he is coming back for another bite of their funding.

Clive Betts: Can my right hon. Friend imagine the reaction in schools in my constituency, such as Birley and Handsworth Grange? They heard the Secretary of State's announcement before the recess and believed that their school programmes would go ahead, yet in October, only a few weeks later, they were told to find a 40% cut in schemes that had already been designed. That does not merely destroy the aspirations and hopes of young people; it is ridiculous and a complete waste of money to have a school designed to such an advanced stage and then cut the programme at the last minute. People cannot find 40% efficiency savings at the drop of a hat.

Andy Burnham: My hon. Friend puts it well. Let us get to the facts. Those schools were told in the summer that they were unaffected. We can work out what "unaffected" means to most people, but the effect of what the Secretary of State has done by coming back for another bite is that he is asking schools in my hon. Friend's constituency to abandon their ambitions for their children so that the right hon. Gentleman can fulfil his ideological ambitions to give funding to whichever schools come asking for it because it ticks the box-it comes forward with the structural form of which he approves.
	That is very wrong. Today, if nothing else, I want the Secretary of State to come to the Dispatch Box and honour a moral obligation, as he has just heard, to the 600 schools that he approved as unaffected. That must mean what it says. Let them get on without the requirement to make unwelcome savings. Instead, the phone calls from his officials have made them scrabble round for cuts. I heard that one school was thinking of stopping all new furniture. Is that what the Secretary of State really wants schools to do? It is mean-spirited. I hope he will honour the commitments that he has made and let them get on and build a better future.

Stewart Jackson: Can the right hon. Gentleman tell the House of any academic or empirical study which directly links the capital expenditure under Building Schools for the Future with enhanced educational attainment? If not, why does he think that that is the case?

Andy Burnham: It is depressing to hear such nonsense from the Government Benches after all these years. Is the hon. Gentleman saying to me that it is acceptable for a school to have leaking roofs or to have no playing field? Is he saying that office blocks are fine for schools? I disagree. I believe that we can do better for our children. If that is a call to cut off the funding to deprived authorities, he should be utterly ashamed of himself.

Karen Buck: Perhaps the hon. Member for Peterborough (Mr Jackson) could enlighten the House by pointing us to any private schools that have outside toilets and leaking roofs.

Andy Burnham: My hon. Friend makes the point. We should aspire to the best possible environment for every single child in this country. We should start where aspiration, expectation and ambition are lowest and transform what those children have. I remember a child in my constituency going into a new school and saying, "It's too good for us." That is what we need to challenge and break down. The depressing comments from the Conservatives show that they have no understanding of the message that the environment sends to a young person.

Bill Esterson: Aintree Davenhill primary school in my constituency is near where my right hon. Friend used to live. Phase 1 of the rebuild is nearly completed, but phase 2 is yet to be approved by the Government. If phase 2 does not go ahead, the children there will be left to learn in a corrugated iron hut, which is freezing at this time of year and boiling hot in the summer. Does my right hon. Friend agree that that is not the kind of facility in which our children should expect to learn?

Andy Burnham: It most certainly is not, although the Conservatives do not seem to mind, as far as I can tell. Such a facility is too good for our children, as far as I can make out.
	Schools all over the country are in chaos because the Department promised a capital review to clear up the problems and give clarity to schools. Instead, schools all over the country are in limbo, waiting to hear. I hope they will hear some clarity from the right hon. Gentleman today. It is clear that he has made a mess of the capital budget, but I hope he will acknowledge today the anxiety in schools right now about revenue budgets for next year.
	"Schools protected" was the headline that schools wanted on spending review day, but here is the second charge that I lay at the door of the Secretary of State: has he not raised expectations that he now cannot fulfil? As the Institute for Fiscal Studies said, when rising pupil numbers are taken into account, the "Schools protected" headline turns into a 2.25% real-terms per pupil cut. Further changes to funding may mean it is far worse for some schools. Specialist schools fear losing the extra money that comes with their status. I hope that today the Secretary of State may provide them with some clarity on that.

Stephen McCabe: Can there be any worse con perpetrated on parents than the cast-iron guarantee that the Lib Dems and the Secretary of State gave on the pupil premium? Is not that a classic example of a promise that did not last until the ink had dried?

Andy Burnham: My hon. Friend anticipates me, because that is precisely the issue that I was about to come on to.
	The big issue facing all schools is the effect that the pupil premium will have on their budgets. The rush to bring in this new system could cause real volatility in budgets. I hope that the Secretary of State will tell us how he is planning to avoid that. It happened to us when we made changes to school budgets; these things need to be done carefully. We acknowledge that problems can arise, but I hope that he will give me, and schools, some reassurance that the Department will have measures in hand to protect schools from very marked swings in their budgets.
	As I told the House on Monday, experts are predicting that schools in the most deprived parts of the country stand to be the biggest losers from the much vaunted pupil premium-amazing, given all the claims made for it by the Liberal Democrats, but, it would seem, true. Today I visited a secondary school in Walthamstow which, by any measure, faces some of the biggest challenges of any school. It has double the national average of pupils on free school meals and with special educational needs. It is very important that the House hears what the pupil premium might mean for them-might mean, because we do not know yet. The school estimates- [ Interruption. ] I do not know what the Minister of State, Department for Education, the hon. Member for Brent Central (Sarah Teather), is chuntering about. This is coming directly from schools. If she listens to this, she might be able to change things and do something about it. The school estimates that it is set to lose hundreds of thousands of pounds under the pupil premium. That is supported by the IFS, which has calculated that the pupil premium could be 2.5 times higher in Wokingham than in Tower Hamlets. It says that schools in more deprived areas would receive noticeably less in percentage terms than similarly deprived schools in less deprived areas.
	May I ask Liberal Democrats to examine their consciences before final decisions are made on this issue? Is this really the effect that they wanted for their pupil premium-to take money off kids for whom life is already hardest?

Dan Rogerson: I have been listening closely to the right hon. Gentleman's comments about what may or may not be in the pupil premium based on the suppositions that he is making. After more than a decade of his Government, pupils in my part of the country were getting much less than the national average despite its having the lowest wages in the country. What did his Government do about that when they had the chance? At least the pupil premium is an attempt at a better suggestion.

Andy Burnham: The hon. Gentleman cannot say that the Labour Government did nothing for education funding in Cornwall-that is an astonishing claim. I hope that he accepts that the needs of schools vary in different parts of the country. I am not arguing that we had perfection, but we did take steps to improve funding for schools all over the country.
	Let me deal, right now, with what the pupil premium will do to schools, including those in the hon. Gentleman's area.

Clive Efford: We hear a lot about fairness from this coalition. It would be completely unfair if a school in a deprived area were to miss out in order to shift money to another school in another area. We should not be playing one school off against another. Should we not hear from the Secretary of State that there will be a minimum by which no school will miss out, and that the pupil premium will be additional money that does not come at the expense of other schools?

Andy Burnham: My hon. Friend has made a very important point. I have invited the Secretary of State to set out how he will ensure that no school sees a huge loss of funding to the pupil premium, with that then causing a problem in terms of service continuation.
	As I said, I ask the Liberal Democrats to examine their consciences, and I got the impression that the hon. Gentleman was thinking about it. If they do not, for goodness' sake they should speak up and show that they have some influence in the Government. They should speak up for the kids in the school that I went to this morning. We need to hear their voice to ensure that the pupil premium is what we were told it would be. At the moment, it is nothing more than a con.
	The real trouble is that we do not have a new and additional pupil premium at all. The danger for the Liberal Democrats is that this issue goes to the very heart of the politics of the coalition. In the post-election talks with Labour, the right hon. Member for Yeovil (Mr Laws) told my right hon. Friend the Member for Morley and Outwood (Ed Balls) that he had secured from the Conservatives a pupil premium additional to a schools budget protected in real terms. Let there be no debate about that-that was what the Liberal Democrats said they had secured.
	The Minister of State, the hon. Member for Brent Central, told the House many times that that would indeed be delivered. Well after the coalition talks, on 7 June, she told us that it would involve
	"substantial extra money from outside the education budget."-[ Official Report, 7 June 2010; Vol. 511, c. 15.]
	That was meant to be the Liberal Democrats' big win, and it was paraded as the consolation prize on the day of the tuition fees announcement. The painful truth for them is that they have failed to deliver it. They have been chewed up and spat out by the Tories. We are now looking at a pupil premium that will take money off her constituency in Brent, where more than 20% of kids are on free school meals, and give it to the Secretary of State's constituency in Surrey, where less than 10% of children receive them. That Liberal Democrat fig leaf of credibility for staying in the coalition has been snatched away.
	Because the education budget is not rising-it is falling in real terms-the pupil premium is simply a relabelling of existing funding. There will be more losers than winners. The IFS estimates that 60% of primary school children and 80% of secondary school children will be in schools whose real budgets are cut. On the day when the budgets for those schools land, the "Schools protected" spin will be wearing very thin indeed.
	The problem with this ministerial team is that they simply have not got a grip on the detail. They simply do not know what the changes will mean for schools. However, the situation is still worse than that. They are also obsessed with costly, untested structural reform. That lethal combination of incompetence and ideology is toxic for our schools. The Government's preoccupation with structures risks a loss of focus on standards. Under Labour, school standards rose year on year, with some of the highest ever results at every stage and the best ever results this year in GCSEs and A-levels. In 1997, half of all schools fell below the basic benchmark of 30% of students getting five good GCSEs graded A to C.  [Interruption.] I hear Conservative Members speaking up, but those were our schools and our children in our constituencies that were being failed. Many children were leaving school without any hope of a better life-that was the reality.

Guy Opperman: Is it not accepted that in science, for instance, the UK has gone from fourth to 14th position? In literacy we have gone from seventh to 17th, and in mathematics from eighth to 24th. That has to mean we have less, not more.

Andy Burnham: I must say, the hon. Gentleman's literacy was very impressive there when he read the Whips' handout. He almost read it word for word, and he did not have any help.
	The hon. Gentleman cannot deny the figures that I have just read out, which show a transformation in our secondary schools. Half of schools were not achieving the basic benchmark in 1997, but today it is fewer than one in 12. Just think how many thousands of kids have hope of a better life because of that transformation in our schools, particularly in our most deprived communities.

Andrew Percy: I will tell the right hon. Gentleman what the reality was in some of the most deprived schools, because I was teaching in some of them. Children were forced on to courses that they did not want to be on simply to shove up standards, and the gap between the best and worst-performing schools widened over Labour's time in office. The reality is that in the area in which I used to teach, children are less likely to progress socially than those from schools elsewhere. Statistics and figures are one thing; the reality is something very different.

Andy Burnham: The reality is very different. Is the hon. Gentleman really saying that head teachers and teachers in primary schools in his constituency would say that there has been no change in primary schools in the past 10 years? Is he really saying that secondary schools have not improved? The figures tell us what has happened. Am I saying, "It's all perfect"? No, I am not, because more needs to be done. We turned failing schools into good schools and I am very proud of what we as a Government achieved for some of the most deprived children in our country.
	It is encouraging that the right hon. Gentleman told the national children and adult services conference recently that he will set new minimum standards for schools-we welcome that continuation of Labour's successful national challenge programme- but he is about to take huge risks with all the progress that we made. One area on which we should both agree is that excellent teaching is the surest route to the highest standards.
	It was with some surprise that I heard the Secretary of State confirm to the House on Monday that his free schools will be able to use public money to hire whomsoever they like to teach, with no teaching qualification requirement. When he took up the job, he said that teachers should have a good 2:1 degree. He should be consistent in this important area: investing in our teacher work force is of fundamental importance to good school standards.

Pat McFadden: My right hon. Friend mentioned the record of higher standards under the Labour Government. Like me, I am sure that he welcomes the fact that young people from the poorest areas are 30% more likely to go on to higher education than they were five years ago. Does he agree that not only higher standards but education maintenance allowances played a significant role in encouraging people to stay on at school, perhaps for the first time in a family? What will be the effect of the Government's plans to abolish education maintenance allowances?

Andy Burnham: I am glad that my right hon. Friend raises that issue. I will spend a moment on EMAs. As we heard at education questions on Monday, the EMA is the subject of huge concern among Labour Members. It is feared that it will be pared back or, worse, taken away.
	The Secretary of State is good with words and is good at making big commitments, but I want to see some follow-through-I want him to stand by what he says. Young people will look to what he or I say, so that they can have trust in politics and in this place. In an interview in  The Guardian on 2 March-just before the election-he said:
	"Ed Balls keeps saying that we are committed to scrapping the EMA. I have never said this. We won't."

Michael Gove: indicated assent.

Andy Burnham: The right hon. Gentleman nods, because he obviously acknowledges the veracity of the quote. Why is such a move acceptable now? Before the election, he made that statement to the young people who receive EMA, some of whom might be watching these proceedings. What are they to make of such a statement? It sounded commendably clear before the election, but now that crucial support is being removed. Throughout Education questions on Monday, his Minister spoke in an offhand way of the dead weight cost of EMA. If I understood him correctly, he meant that 90% of young people would have gone into post-16 studies anyway. For young people who come from homes where incomes are low and do not have much support, this allowance can mean the difference between having to get a part-time job or having to walk to college because they cannot afford the bus fare. The EMA allows them to focus on their studies, which gives young kids from backgrounds where life is hardest the chance to exceed expectations and excel in further and higher education. When I heard the Minister on Monday, I did not feel he had any appreciation of the fact that the EMA makes it easier for those young people to fulfil their potential and be the best that they can be.

Rushanara Ali: Since 2004, more than 22,000 people in Tower Hamlets, where my constituency is, and nearly 500,000 people across London, have received the EMA. Only last night, a constituent, who is now reading law, told me that he could not have studied without the EMA. Does my right hon. Friend agree that, throughout the country, those on low incomes will be prevented from taking up higher education places if the matter is not reconsidered? I make a plea to the Government to think again.

Andy Burnham: My hon. Friend makes a powerful point. Labour Members have been struck by the concern among young people about the EMA. Taken with the tuition fees announcement, the one on the EMA is having a depressing effect on the aspirations of young people who have least. That is the great worry about what is happening. I hope that the Secretary of State has heard my hon. Friend's words.

David Lammy: Given those young people's anxiety and the increase in tuition fees to £9,000, does my right hon. Friend think it acceptable that the schools Minister seems happy to sit on her BlackBerry?

Andy Burnham: That is not acceptable, nor is it acceptable to chunter and object throughout when many of the points that have been made should be listened to. My right hon. Friend the Member for Tottenham (Mr Lammy) did so much work on the EMA and on lifting young people's hopes in constituencies such as his.
	We must also take into account the changes in child benefit for families with a higher earner because, although they may not be eligible for the EMA, some give the child benefit to the young person in further or higher education, which helps young people get through. The removal of child benefit will further damage staying-on rates.

Anne Main: I am interested in the right hon. Gentleman's comments about the EMA. Will he give me some statistical evidence that directly relates improvement in educational attainment to the EMA?

Andy Burnham: I am looking through my notes-I do not want to cite the wrong figure. There is evidence that 18,500 young people stayed on at school, who would not have done so without that financial support. That means 18,500 young people with the hope of a better life because of the EMA. Why do the Government want to abolish it? I am lost for words.

Ian Mearns: If Government Members are looking for evidence, a collection of college principals in north-east England wrote to me asking me to point out to the Government at every stage the real dangers that they perceive to youngsters going into further education from the abolition of the EMA. That applies across the board in the north-east.

Andy Burnham: There is evidence, so we will write to the hon. Lady with it. There is supposedly a successor scheme, but, if the Government are to replace the EMA, will she and others on the Government Benches ensure that it is with something that gives young people some hope? If the proposal is simply to cut support to the poorest, she will set back the cause of opportunity for all in this country.

Alison McGovern: If my right hon. Friend is looking for evidence, I suggest the case of one young woman in my constituency whom I helped during the election campaign. She came to me, worried about her EMA, which she had trouble getting from the school. I helped her with the head teacher. I later found out that she was the sole carer for her mother, who was blind. She would have gone to school anyway, because she was utterly determined, but the EMA gave her and her mother a quality of life that they did not know previously.

Andy Burnham: Listening to the responsible Minister on Monday at Education questions, one would have come to the conclusion that he had no appreciation at all of the effect the EMA could have on a young person's life in those circumstances. I said that the Government should listen to students. I hope that they will, and that they will meet some young people who currently benefit from the EMA such as the person about whom my hon. Friend just spoke. The EMA is a lifeline. For young carers, who have been in the news this week, it represents the hope of a better future, and I hope that the Government will not wipe away their hopes and dreams.

Barry Sheerman: One of the big consultancies-I believe it was PricewaterhouseCoopers-conducted a full evaluation of the relationship between the EMA and improvements in rates of staying on and entering university, and in evidence given earlier this year to the Children, Schools and Families Committee, which I chaired, made it clear that that relationship was very positive.

Andy Burnham: I hope that the Government will take account of my hon. Friend's point because there is good evidence to show that the policy has been a success and is helping many more young people stay on in education and achieve.

Dave Watts: Is my right hon. Friend as depressed as I am about the fact that the Government seem to be saying that financial assistance to families does not matter, the poor state of school buildings does not matter and the overall funding package for education does not matter? What seems to matter is that both the Liberals and the Conservatives are determined to cut education spending and push people back into deprivation.

Andy Burnham: That is the inference that people will draw. There is an obsession with structures, not with standards or with helping young people to be the best they can be. I would like to hear the Secretary of State talk a little more about that and a little less about free schools and whatever structural ideas he is dreaming up. Let us focus on standards and on the aspiration of kids from a working-class background. Let us give them some hope rather than introducing organisational reforms that may or may not offer them anything. That is the problem the Secretary of State is facing.

Stephen McCabe: I would like to help the hon. Member for St Albans (Mrs Main), who asked about the EMA. Did not the Institute for Fiscal Studies publish a report showing a rise of six percentage points in the number of EMA recipients getting level 2 qualifications? That is hardly a Labour party assertion, is it?

Andy Burnham: Not at all, and the report also showed specific improvement among groups who have traditionally under-achieved in post-16 education. The Government seem to be saying that this evidence is simply to be disregarded because a political decision has been made. At times, I get the feeling from this Government that if a reform was introduced by Labour, they just want to wipe it away, even if it was successful. They want to do something different.  [Interruption.] Well, we shall talk about school sport in a minute, and I think they are also guilty of the charge on that issue.

Nicholas Dakin: Evidence from the IFS and the CfBT Education Trust clearly demonstrates that the EMA has benefited students. As a former principal of a sixth-form college, I have seen the impact on students. We did our own evaluation, which showed higher attendance among students on the EMA than among those who were not, and a direct correlation between their attendance and attainment.

Andy Burnham: My hon. Friend makes an important point. His experience matches exactly that of my brother, the vice-principal of a sixth-form college in St Helens. The change to EMA needs to be looked at alongside potential changes to the funding of post-16 education-the funding available to sixth-form and FE colleges-because it could have a very damaging effect. There is also a rumour-I do not know whether it is true-that people will no longer get free A-levels beyond the age of 18. Will the Minister for Further Education, Skills and Lifelong Learning address that point today? All those proposals will combine to take away opportunities.

Damian Hinds: Will the right hon. Gentleman give way?

Andy Burnham: I am now going to wind up my remarks. Some of his colleagues will be happy about that, even if he is not.
	The Government's policy is an ideological gamble. Schools will be able to use money to employ whomsoever they like, even if that person has no qualifications, in any premises, which, as we have heard, might include converted prisons, bingo halls, hairdressers and pet shops.
	What guarantees do parents have that the Secretary of State's free schools will have the highest standards? What guarantees do they have that they can hold those schools to account if they do not meet such standards? The truth is that free schools are a risky ideological experiment being pushed through at speed with a lack of reliable evidence. Is not there a real danger that one person's decision to create a free school will undermine existing good provision in an area and a school's ability to improve?
	Should not access to safe outdoor space and sports facilities be a right for every single child?

Andy Slaughter: My right hon. Friend will know that I have the misfortune that the local authority in my area is one of the ideological dustbins of the Conservative party. It adopts all these initiatives, so we have three of the 16 new free schools, but there are no suitable sites for them. Existing community organisations are being evicted from their premises so that a few free schools can take them over, despite the fact that their catchment areas are outside the borough and the area. How is that localism or parent choice? Is it not the triumph of ideology over education standards?

Andy Burnham: I had the good fortune to meet head teachers from my hon. Friend's constituency very soon after I came into this job. They told me how that cluster of free schools could undermine other local schools. I am at a loss, and I wonder whether the Secretary of State can help me. Why is a school specialising in Latin exactly what Acton needs? I am yet to be persuaded that that is the best route for modern education in west London.
	I mentioned outdoor space. A good example of schools achieving more together than they can alone is sport. School sports partnerships are a wonderful example of schools working together. The Australians have described our system as world class. I urge the Secretary of State to think again on that. School sports partnerships, which created a new delivery system for school sport, have worked well and given more opportunities to young people. I hope that he is open to the arguments of Darren Campbell and others who are pleading with him to keep that infrastructure rather than dismantle it.
	My worry is that in the long term the free school experiment will lead to a much more segregated schools system-a splintered system in which narrow social groups impart a narrow world view. Are we heading towards an unaccountable free-for-all in our local education systems? Experience in Sweden suggests that the Secretary of State's schools will have a negative impact on standards.

Graham Evans: Will the right hon. Gentleman give way?

Andy Burnham: I will not.
	I have never heard how that negative impact will be addressed in the Secretary of State's world view, in which schools are free to fail. I am worried that he is creating a world where each school exists within a walled garden, with no obligation to other schools. The local authority co-ordinating role is important, and I cannot see why the Government want simply to wipe it away with a national funding formula. Local authorities look out for the needs of all children within an area, including the vulnerable and the voiceless. Who will speak up for them in his brave new world?
	My vision is of a truly comprehensive education system, in which there is diversity of provision, and in which we help all children to be the best that they can be. I want a collaborative rather than a competitive system, and I want all schools to recognise their obligations to each other. I am worried that the Secretary of State is creating an elitist education system.
	We fear that Sure Start centres are about to close, and we heard today that the pupil premium will take money from some of the most deprived communities in our country. We have just had a debate on how the Government's policy on EMA could depress aspirations, particularly those of working-class kids. We have heard that the Secretary of State, in closed meetings in Westminster, has nodded and winked to the effect that his foot is hovering over the pedal when it comes to allowing more selection and allowing grammar schools to use the free school route to set up more grammar schools. He needs to come clean on those things. Does he want to create a more elitist system, where opportunities exist for the few but not the many?
	That is the Opposition's critique of the Secretary of State. We have had broken promises and free market reforms with no evidence, and there is a whiff of elitism in everything the Department introduces. That spells danger for our schools. We need a plan not just for some schools, but for all schools. That is what our motion is about, and I commend it to the House.

Michael Gove: May I offer a few words of heartfelt thanks to the shadow Secretary of State? Today we announced a radical extension of academy freedoms for many more schools, allowing weaker schools to be supported by stronger schools, in a culture of collaboration that drives up standards for all. This afternoon, in No. 10 Downing street, I along with the Prime Minister met hundreds of head teachers in the state system who have taken advantage of academy freedoms to drive up standards not just for their children, but for others in their local areas. After that morning good-news announcement and that afternoon celebration, I ask myself: what could we do to top it? I am so grateful to the right hon. Gentleman for giving me this opportunity to explain to the House of Commons the radical, comprehensive reform programme that we are introducing that will help to transform opportunity for the very poorest.

Several hon. Members: rose -

Michael Gove: There are three Opposition Members who are eager to intervene. It is difficult to know to which of these young lads I will now give the opportunity to shine.

Dave Watts: May I suggest that the right hon. Gentleman go to Specsavers? The Secretary of State has said that he has met a group of head teachers from academies. Will he meet the other hundreds of head teachers who are desperately waiting to see whether their schools will be modernised and the holes in their roofs fixed? Will he be as keen to meet them as he has been to meet the academy heads?

Michael Gove: I am always keen to meet head teachers, and the more head teachers I meet, the more I find that they say the same things: that under this Government, they are at last being treated properly. At last, in the words of Mike Spinks, a head teacher from Stretford and Urmston, the baseball batting of bureaucracy has ended. At last, in the words of Patricia Sowter, a head teacher from the Labour constituency of Edmonton, head teachers are being given the opportunity to do what they have always done, which is to stress the importance of helping the very poorest. At last, in the words of Sir Michael Wilshaw, a head teacher who teaches in the Labour constituency represented by the hon. Member for Hackney North and Stoke Newington (Ms Abbott), we have a Government who are on the side of extending academy freedoms. I talk to head teachers all the time. When I do, the one thing I say to them is: "You've got a Government who're on your side," and the one thing that I hear from them is: "At last."

Chuka Umunna: rose -

Michael Gove: Later.
	The right hon. Member for Leigh (Andy Burnham) asked whether I played poker. I have to confess that when I was growing up and learning card games, poker was somewhat frowned upon at the Kirk socials that I attended, although we did play the odd game of knockout whist. One of the things that I learned in card games is that one has to play the hand that one is dealt. What was the hand that we were dealt by the right hon. Gentleman and his colleagues? Credit agencies ready to downgrade our debt; a £150 billion deficit; and a letter, left by the former Chief Secretary to the Treasury, saying that there is no money left. I know that that is painful for Opposition Members to hear, but it is even more painful for the people in our school system who have been let down by the profligacy, arrogance and extravagance of a party that still does not have the humility to say sorry for debauching our finances.

Pat McFadden: The Secretary of State mentioned the academy programme. I am a supporter of the academy programme that the Labour Government introduced. It gave hope and higher standards to children who had not been given the opportunities that they deserved under what went before. Earlier this year, he issued his list, which said that the Building Schools for the Future programme in the city that I represent would be unaffected by the changes, and that programme includes two city academies, one of which is in my constituency. However, they are now being told that there will be a cut in that programme of up to 40%. How can he say that the programme is unaffected and that that will not have an impact on opportunity for those children who need it most?

Michael Gove: I am grateful to the right hon. Gentleman, for whom I have a great deal of respect. He was a very good Minister, and it is a pity that he is not on the Opposition Front Bench now. I absolutely share his commitment to improving academy provision, not just in the west midlands, but across the country. I can reassure him that all those schools that were recorded as being unaffected will have their building work backed. The money will be there, but we have a duty, to both the taxpayer and those schools, to ensure that when we negotiate with the contractors-with the private sector-we get the best possible value for money. The more money we can save in our negotiations with contractors, the more we can invest in education elsewhere to ensure that the many, many school buildings that are in a state of dilapidation and extreme need receive additional support. I know that the right hon. Gentleman-when he was a Minister, he always sought to secure value for money for taxpayers-will appreciate that that tough negotiation on behalf of the public is exactly what a responsible Government should do.
	Hon. Members know that education standards should not just be measured against the past. Countries across the globe are improving relative to the past. We need to measure ourselves against the best in the world. As my hon. Friend the Member for Hexham (Guy Opperman) said, the grim truth is that the statistics produced by the OECD show that over the past 10 years, educational standards in this country, relative to other nations, have fallen. We have moved from being fourth in the world for the quality of our science education to 14th, from seventh in the world for the quality of literacy to 17th, and from eighth in the world for the quality of mathematics to 24th. Those are facts that we cannot deny. At the same time as we have fallen behind other countries, the gap between rich and poor, as my hon. Friend the Member for Brigg and Goole (Andrew Percy) said, has grown wider.
	In the last year for which we have figures, the number of children who were eligible for free school meals, bearing in mind that every year 600,000 children attend state schools, was 80,000, of whom just 45 made it to Oxbridge- [ Interruption. ]. It is absolutely the measure. The right hon. Member for Leigh might not like to hear it, but on his and his Government's, watch the poorest children were denied opportunity. He made it to Cambridge; why should not more children from poor homes make it to Cambridge and Oxford? Why do children from Westminster, St Paul's, Eton and such bastions of privilege make it to Oxford and Cambridge but not our poorest children in state schools? This Government-the Conservative party and the Liberal Democrats united together-are at last investing in social justice, and I hope that the right hon. Gentleman will acknowledge that that figure is a scandal and that at last the investment is going in to secure reform.

Andy Burnham: I am grateful that the Secretary of State acknowledges that I have some knowledge of these matters. He lays all the blame for that figure at the door of the school system in England. Why does he not place any of the blame at the door of Cambridge university and Oxford university? Is he saying that there is no talent in state schools?

Michael Gove: The talent is there, but such children do not get in because they do not have the opportunities that they deserve. The school system has failed them. They do not get in because in the school system children from poorer homes fall behind their wealthier compatriots at every step of the way. At key stage 1, the gap grows wide; at key stage 2 it grows wider still. Children from wealthy homes are twice as likely to get five good GCSEs as those who are eligible for free school meals. That is entrenched inequality in our school system. The Labour party had 13 years; they did not take action, and now they blame others instead of taking responsibility.

Andy Burnham: I am disappointed that the Secretary of State lays all the blame at the door of our schools. When I went to Cambridge in the late 1980s, the proportion had just changed, and the majority had just become children from state schools at 51% with 49% from the independent sector. The figures today are around 55% from state schools, 45% from the independent sector. I am not saying that schools cannot do more to encourage the highest level of aspiration, but is he saying that the Russell group and the most elite universities in our country can do nothing more to open their doors and to operate less elitist admission policies?

Michael Gove: The right hon. Gentleman is taking no responsibility for what happened on his watch, for the inequality in the school system, and for taking no steps to deal with the mess that was left to us. We are the party that is saying to Russell group and elite universities that they must do more to ensure that talented children can go to top universities. Unfortunately-this is a fact that he cannot run away from-social mobility went backwards on his watch. This country is less equal as a result of a Labour Government. There were 13 years of shame and 13 years of hurt, and the Labour Government were responsible.
	In place of the Labour Government's failure, we are introducing a wide range of reforms, all of which are based on best international practice and all of which have been proven, in other nations, to drive up standards. We are ensuring that we learn from all the best performing education nations. We are improving teacher recruitment and training. It is our Government, not theirs, who have doubled the number of students entering Teach First, to ensure that we have top graduates going into the most challenging classrooms. It is our Government, not theirs, who have changed the rules on discipline and behaviour to provide teachers with stronger protection and to ensure that we no longer have the absurd situation in which teachers have to wait 24 hours before issuing a detention to an unruly pupil. It is our Government, not theirs, who are changing the national curriculum and introducing an English baccalaureate to ensure that all students, from whatever background, have access to an academic core by the age of 16.
	It is our Government, not theirs, who are reforming key stage 2 tests to ensure that all students have accurate information on their progress at primary school, and that we end the damaging "teaching to the test" that has characterised those tests in the past. It is our Government, not theirs, who have given head teachers in all schools the degree of autonomy and independence for which they yearned for 13 years. So it is unsurprising that, in the 37 minutes of the right hon. Member for Leigh's speech-[Hon. Members: "Forty-seven!"] Forty-seven? Just see how numeracy went down on Labour's watch. In the 47 minutes of the right hon. Gentleman's speech, there was not a single new idea on how to improve our state education system. He is an IFZ: an ideas-free zone. Those beautiful eyelashes might flutter, but behind them there is a dusty plain where a single idea has yet to take root.

Several hon. Members: rose -

Michael Gove: Talking of beautiful eyelashes, I am happy to give way to the hon. Member for Streatham (Mr Umunna).

Chuka Umunna: I find it quite extraordinary to hear the Education Secretary's comments about increasing the participation of people from deprived backgrounds, in the light of his reforms of higher education financing. Can he tell us how introducing tuition fees of up to £9,000 will increase the participation in higher education of people from deprived communities- [ Interruption. ] The right hon. Gentleman has been talking about Oxford and Cambridge, and other universities, and he should answer my question.

Michael Gove: The debate today is about schools, not about higher education. However, I would be delighted to have a debate about higher education. It would be interesting to know who would represent the Opposition in such a debate. Would it be the Leader of the Opposition, who believes in a graduate tax, or the shadow Chancellor of the Exchequer, who denounces such a tax? Would it be the right hon. Member for Wolverhampton South East (Mr McFadden)-who is no longer in his place-who backs the Browne reforms, or would it be the hon. Member for St Helens North (Mr Watts), who opposes them? The truth is that, on higher education, there is a split in the Labour party as wide as the River Jordan between those who are genuinely progressive and back our reforms and those who are regressive and oppose them- [ Interruption. ] Hon. Members ask who introduced tuition fees. The Labour party did that, and in so doing, broke a manifesto promise- [ Interruption. ]

Lindsay Hoyle: Order. I must remind hon. Members that this is a debate on schools, and not on higher education. I am sure that the Secretary of State would not want to open up another debate.

Several hon. Members: rose -

Michael Gove: I shall give way to my hon. Friend the Member for Peterborough (Mr Jackson).

Stewart Jackson: I hesitate to derail my right hon. Friend's peroration, but related to his point about the badge of shame and ignominy attached to the record of the last Labour Government is the number of children in care and the fact that the educational attainment of the most vulnerable in society actually went backwards under their time in office. Should not those on the Labour Front Bench hang their heads in shame about that?

Michael Gove: My hon. Friend makes a very good point. His commitment to looked-after children and children in care has been consistent, both before he entered the House and now that he serves with such distinction here. One of the reasons that the Under-Secretary of State for Education, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) is taking such pains to change the rules on, for example, adoption and to work with looked-after children is that the vulnerable and the voiceless need our support. I hope that the efforts that we are all making to ensure that they enjoy a better future will be backed across the House.

Fiona O'Donnell: If the right hon. Gentleman is really serious about increasing social mobility, will he explain how the double whammy of getting rid of the child trust funds and the education maintenance allowance will achieve that?

Michael Gove: We are increasing social mobility by reforming our school system. Let me mention one striking thing about the changes we are making. According to the right hon. Member for Leigh, these changes are an ideological experiment, so who is backing these changes? Who are the extremists who support what the Government are doing? Who are the figures with whom we are ashamed to be associated, who are saying that our ideas are right? Well, what about Arne Duncan, Education Secretary in Barack Obama's Administration? The other week, he said:
	"I just have tremendous respect for the educational work and the leadership that I've seen coming from the UK and we're all working on the same issues and have the same challenges."
	He also said that the coalition Government were
	"pushing in all the right areas"
	on education policy. He said that I am
	"working very, very hard, and I love his sense of urgency, I love his willingness to challenge the status quo when things are not working".
	So we are backed by Barack Obama.  [Interruption.] It was his Education Secretary, but we all know that he speaks for the President.
	Talking of international statesmen- [Interruption.] Not Toby, but Tony-Tony Blair. The former Prime Minister, who knew about winning elections and how to lead the Labour party to victory, wrote:
	"In many areas of domestic policy, the Tories will be at their best when they are allowed to get on with it-as with reforms in education."
	We shall come back to some striking things about the former Prime Minister's words. I remember when the right hon. Member for Leigh was a Blairite-although that was before he was promoted by the right hon. Member for Kirkcaldy and Cowdenbeath (Mr Brown), but there we are.  [Interruption.] Oh, yes, he was one of the plotters, but we will come back to that later. It is striking that the arguments that the former Prime Minister made at every stage in favour of educational reform are now rejected by the Opposition. In 2005, Tony Blair said:
	"In our schools... the system will finally be opened up to real parent power... All schools will be able to have Academy style freedoms... All schools will be able to take on external partners. No one will be able to veto parents starting new schools or new providers coming in, simply on the basis that there are local surplus places. The role of the LEA will change fundamentally. There will be relentless focus on failing schools to turn them round... schools will be accountable not to government at the centre... but to parents, with the creativity and enterprise of the teachers and school leaders set free."
	I agree with those words, but I do not know whether the right hon. Member for Leigh does, as he opposes every single one of the points made in that quote. He opposes extending academy-style freedoms to all schools. He wants to veto parents from starting new schools. He does not want the role of the local authority to change fundamentally, and he does not want the creativity and enterprise of teachers and school leaders set free. Why is that? Why are the real conservatives now sitting on the Opposition Benches?

Mike Gapes: What safeguards are there against extremists, including Islamists and creationists, setting up free schools?

Michael Gove: As the hon. Gentleman will know, I have a consistent record of opposing Islamic extremism. One thing we have done is to set up a new due diligence unit within the Department in order to ensure that the threat of extremism-not just from anyone who might wish to promote a free school, but from anyone who wishes to infiltrate our state school system-is dealt with. The hon. Gentleman will be aware that in both Surrey and Birmingham there were genuine dangers due extremist influence in state schools. I take the issue very seriously and I am delighted to work with others such as the hon. Member for Birmingham, Perry Barr (Mr Mahmood) in helping to counter it.
	That brings me to another key point on which I agree with Tony Blair-no slouch when it came to opposing Islamist extremism. If we automatically assume that any parent who believes it is right to set up new schools is an extremist, we are saying to the overwhelming majority of people in this country who want better state education, "I am sorry; you are outside the mainstream".

Chris Bryant: The Secretary of State refers to deprivation and how to tackle it. He will know that the inheritance of teenage pregnancy is an issue that affects deprivation and the poverty of ambition of many families. If we look at the map of teenage pregnancy in this country, we see that it is also the map of deprivation. I acknowledge that we did not have complete success on this issue, although we had partial success. We cut the numbers. They had risen dramatically under Mrs Thatcher's era. They fell in ours, but not as much as we would have liked. I think that was partly because we did not learn the lessons from countries such as Holland-where the figure is five times lower than it is in this country-and introduce statutory sex and relationship education. Will the Secretary of State think again about his opposition to that?

Michael Gove: The hon. Gentleman has been a consistent proponent of better sex and relationship education, but I have to tell him that it is a statutory part of the present curriculum. The critical question is how we can improve the quality of guidance and the quality of teaching. The hon. Gentleman is passionate, and in this respect his passion is in a good cause, but I fear that he has got his facts wrong. Sex and relationship education is already compulsory; personal, social and health education, which is a broader issue, is not yet compulsory in the national curriculum. Now that I have cleared up that confusion on the hon. Gentleman's part, I hope that we can work together to ensure that our sex and relationship education reflects 21st-century values. I have been delighted to work with Liberal Democrat colleagues to achieve just that.
	I have quoted politicians who back our reforms, but it is important for us to hear from teachers as well. I mentioned head teachers earlier, but let me run through what some are saying about coalition policies. These are head teachers who have taken advantage of the changes that we have made: changes that the right hon. Member for Leigh said had been introduced in a rush, and were ill-conceived and ideological.
	Headmistress Lesley Grace, of Seaton primary school in Cumbria, says that as a result of our changes
	"we can be totally focused on our age group and our community... we can target resources to employ specialist staff, such as speech and language therapists or reading intervention specialists."
	The school could not do that before.
	At Durand primary school in Stockwell, London, 52% of pupils are eligible for free school meals. What does the head teacher say when he thinks about how to improve outcomes for those poor children? He says:
	"Academy status does give us greater freedom to deliver an even more bespoke education, tailoring it to the needs of our specific intake."
	He says that the school is giving more
	"time and space in the curriculum back to subjects like sport and music, the importance of which have been lost over recent years."
	What about Patricia Sowter, headmistress of Cuckoo Hall school in Enfield, whom I mentioned earlier? She says that academy status enables her to invest more in
	"training, development and non-contact time for senior teachers."
	Jonathan Bishop, headmaster of Broadclyst primary school in Devon, says that academy freedoms give him the opportunity
	"to deliver an outstanding environment"
	for his students, adding
	"I don't understand why anyone would not want to do it."
	As a result of academy status, the headmaster of the Premier academy in Milton Keynes can
	"employ two or three more teachers to cut class sizes."
	While we are talking about smaller class sizes, let me cite Paul Gazzard, head teacher of St Buryan school in Penzance, who has been able to bring the average class size in his school down to 18 by introducing academy reforms.
	The question for the right hon. Member for Leigh is this: will he reverse these changes? He opposed them, which is fair enough. It is understandable. A new, keen, young Opposition spokesman is entirely entitled to fly an opportunist flag, but now that real schools and real pupils are benefiting, the question for him is this: will he turn the clock back?
	I have more confidence in the right hon. Gentleman than in his predecessor. I think he will see that our changes are bringing real improvements, and I do not think he wants to turn the clock back. However, that is the test for Labour Members. Are they ready to embrace reform and to acknowledge that it is now the coalition Government who are delivering improvements in state education, or do they want to go back to where they were in the 1980s? Do they want to go back to being the voice of the conservative teaching establishment? Do they want to be the voice of those individuals in trade unions who are opposed to reform and opposed to change?
	We should bear in mind the words of Tony Blair. When he was introducing his reforms, there were Labour Members-although not many-who opposed them. He said:
	"Parts of the left will say we are privatising public services and giving too much to the middle class."
	That is broadly the case made by the right hon. Member for Leigh; but Blair continued:
	"both criticisms are wrong and simply a version of the old 'levelling down' mentality that kept us in Opposition for so long."
	If we are to extend opportunity more widely, we need to ensure that the head teachers whom I have cited, and the others who are anxious to take advantage of these reforms-to invest in improving teacher quality, to invest in better discipline and behaviour, and to invest in higher academic standards-are given the freedom to do so.

Emma Reynolds: The Secretary of State has spoken passionately about extending opportunities for the poorest children in our country, but let me tell him something. On Friday I shall be meeting the head teacher of Our Lady and St Chad Catholic sports college in my constituency. She is deeply concerned about what we suspect is the Secretary of State's intention to withdraw the specific budget for specialist sports schools. That school is in a deprived area of my constituency, and it has both raised educational standards and improved health conditions for young people in the area. Will the Secretary of State reconsider?

Michael Gove: The hon. Lady makes a strong case on behalf of her constituents and that head teacher, who I am sure is doing a superb job, and I can assure all head teachers whose schools enjoy specialist status that what we are doing is removing the bureaucracy which had attended specialist status. All schools will now receive the money through the direct schools grant, and as a result they will be able to spend it as they think fit, not as bureaucrats decree.
	On the subject of funding, I want to pay particular tribute to my Liberal Democrat coalition partners. They came under attack from the right hon. Member for Leigh, but I think it is only fair to say the following. Before the general election, Liberal Democrat coalition partners made the case for the pupil premium passionately, fluently and effectively. It was a policy I supported, but it had been developed with particular attention to detail by the right hon. Member for Yeovil (Mr Laws), and it was first promoted by the Minister of State, my hon. Friend the Member for Brent Central (Sarah Teather). As a result of the case that was made by Liberal Democrat members of the coalition, this Government are now delivering a pupil premium that is worth £2.5 billion in additional spending after four years.

Several hon. Members: rose -

Michael Gove: Just a second. That £2.5 billion of additional money is on top of another £1.1 billion of additional spending to deal with demographic changes, so there is £3.6 billion in additional spending on schools, targeted towards the very poorest-spending that the right hon. Member for Leigh and others consistently opposed, and which they rejected during coalition negotiations. It is spending that has been delivered by a coalition Government-two parties united in pursuit of social justice-after one party had let those children down.

Annette Brooke: I greatly welcome the fact that children in my constituency who come from disadvantaged backgrounds will be supported in their education. However, I would like an assurance from the Secretary of State that this is extra money, and that it does not involve taking money away from schools in deprived areas.

Michael Gove: I am delighted to be able to give the hon. Lady that assurance, and I can do so because the case for the pupil premium was made so passionately by her parliamentary colleague the right hon. Member for Yeovil, and because it was then delivered thanks to the hard work of the Minister of State, the Chief Secretary to the Treasury and the Deputy Prime Minister.  [Interruption.] All of them worked together to ensure that we have £2.5 billion extra.

Several hon. Members: rose -

Michael Gove: Labour Members are upset and annoyed and are heckling because it is this coalition Government who are delivering for those poorest children and they hate that. We can see on their faces their anger and annoyance that it is the coalition parties that are at last delivering on social justice and progressive reforms, and that are improving the school system.

Andy Burnham: It was Labour that gave local authorities funding to raise standards in the poorest areas. The Institute for Fiscal Studies said we had an implicit pupil premium; the Secretary of State might care to read its research.
	Let us stop shifting the ground. The commitment the Liberal Democrats said they had was for a pupil premium additional-on top of-a schools budget protected in real terms; that is not just the dedicated schools grant, but the entire schools budget. Have they got that? This is fundamental. Let us have no fine words from the Secretary of State; he must get to the heart of that question. Have the Liberal Democrats got what they told the former Education Secretary, my right hon. Friend the Member for Morley and Outwood (Ed Balls), they had during those post-election talks? We need to know.

Michael Gove: I think the right hon. Gentleman is talking about schools rather than education, but the truth is, yes, the Liberal Democrats have got a fantastic deal-and more to the point, so has the country. There is £3.6 billion extra; £2.5 billion extra spent on schools, and £1.1 billion extra spent on demography, so there is a real-terms increase in education spending, and delivered over four years, whereas the right hon. Member for Morley and Outwood (Ed Balls) was going to deliver additional spending only for two years, not four years. More than that, he was not going to deliver, as we have, additional pre-school learning for the poorest two-year-olds. He was not going to deliver, as we have, an extra £150 million to help students from poorer backgrounds to go to universities. He was not going to deliver, as we have, an additional £7 billion over the lifetime of this Government to help the very poorest children. The reason why all Labour Members are so anxious to try to attack this proposition is that they hate the fact that progressive policies are being delivered by a coalition Government.

Several hon. Members: rose -

Michael Gove: I am conscious that many Back Benchers, on both sides of the House, wish to contribute. I am also aware that the Opposition motion asks us all, but particularly the Government, to
	"work with families, teachers and communities to deliver improved standards of learning and teaching in all local schools."
	But how? Nothing in what the shadow Secretary of State said today, what he said in his speech to the Association of Directors of Children's Services or what he has said in any interview that he has given constitutes a new or fresh, radical or reforming idea to improve our education system. What do the Opposition offer? How are they going to work with schools, local authorities and parents to improve education? Are they just going to hold hands and sing "Kum ba ya"? Are they going to close their eyes and wish really hard? Are they going to cross their fingers and hope that Tinkerbell will somehow magic a better education system into place? Why can the Opposition not give us a single solid idea for reforming our schools system? It is because they have abandoned reform and instead prefer the opportunism of opposition.

David Ward: Now will the Secretary of State answer the question: is it £2.5 billion on top of cash balances or is it £2.5 billion in real terms on top of what schools are now receiving?

Michael Gove: It is £2.5 billion on top of the cash settlement that schools have been given. It is a real-terms increase in schools spending and £3.6 billion overall. [Interruption.] I think that the hon. Member for Bradford East (Mr Ward) is probably off to celebrate the good news. The truth is that this spending could not have been delivered by the Opposition, because they were not committed to taking the tough decisions that we have taken in order to invest in schools spending.

Bill Esterson: Is the truth not that the Institute for Fiscal Studies figures clearly show that because of increasing pupil numbers this will amount to a 2.25% cut in real terms-not an increase, but a cut-and that the most disadvantaged areas will lose out as a result of the proposals that the Secretary of State wants to introduce on the pupil premium?

Michael Gove: Absolutely not. Schools spending will rise in real terms over the lifetime of the coalition Government. That was not a promise that the Opposition were able to give; they could promise only to increase spending over two years. As I say, we are also extending 15 hours of pre-school learning to all disadvantaged two-year-olds-the Government of the right hon. Member for Kirkcaldy and Cowdenbeath were not able to deliver that. We are also giving £150 million to help disadvantaged students from poorer backgrounds to make it to university.

Graham Stuart: The Opposition are complaining about any possible changes to areas of deprivation, but it is not areas that we need to be concerned about-areas of Sheffield that were some of the wealthiest in the country were getting additional money. What we need to do is ensure that money follows the pupil. The gap between children on free school meals and the rest is wider in the East Riding of Yorkshire, including my constituency, than in any other part of the country. We need a pupil premium that follows children wherever they live, so that we have a more just system that does narrow that gap, which sadly widened under the previous Government.

Michael Gove: My hon. Friend makes a good point and we need to narrow the gap. The gap between children who are eligible for free school meals and other children across the country is far too wide. We need to ensure that disadvantaged children receive additional funding, and under the coalition Government they will receive such funding on top of the dedicated schools grant that was not going to be delivered by the Opposition.

Several hon. Members: rose -

Michael Gove: I am conscious that a number of Back Benchers want to contribute, so I shall now draw my remarks gently to a close.
	The change in Opposition policy since 2005 has been remarkable. A party that was once committed to education reform is now committed to putting the clock back. It is those on this side of the House who are investing more money in the education of the poorest, who are recruiting more great teachers into our most disadvantaged schools, who are changing the policy on discipline, who are reforming the allocation of funds for children with special educational needs, who have ensured that academies admit children with special educational needs on a level playing field, who have extended the Freedom of Information Act to academies, and who are ensuring that vulnerable children at last receive the opportunities they deserve. It is those on this side of the House who are at last trusting teachers and head teachers to do what they have yearned to do for 13 years-to take control of the education system and to transform it in the interests of all our children. For those reasons, I invite the House to reject the Opposition motion.

Several hon. Members: rose -

Mr Speaker: Order. A large number of Members want to take part in the debate and, as usual, time is our enemy. I have therefore decided to reduce the length of Back-Bench speeches from seven minutes to a maximum of six minutes from now on.

Barry Sheerman: I support the Opposition motion. The Secretary of State evaded interventions from me and from several others on the Labour Benches after he said that we were "angry" that the coalition Government were introducing a pupil premium. May I inform him that the Labour Government had a pupil premium? I do not know if it was as well worked through as it should have been; it was an early policy introduced by my right hon. Friend the Member for Sheffield, Brightside and Hillsborough (Mr Blunkett) that was absorbed and no longer ring-fenced when Charles Clarke became the Secretary of State. There was a pupil premium, but I would challenge the Secretary of State. He knows that the Opposition want more resources to follow people from deprived backgrounds. If he is honest with the House and in his intellectual engagement with the debate, he also knows that the most difficult thing is to find a method of ensuring that the money tracks the right people.
	The Secretary of State will find it difficult, as we did with Sure Start children's centres. We started, as he knows, with 500 in the 500 most deprived communities, but we then discovered that that left out most of the deprived children in our country so we moved the number up to 3,500. One of my concerns-and a concern of Members on both sides of the House when they talk frankly in private-is that we might see a drastic cut in the number of children's centres, based on the idea of going back to the original intention of having 500, which would exclude most children from deprived backgrounds. That has a parallel in the pupil premium. The Opposition are arguing that the way in which the Government propose to introduce the premium means that it will fail to reach the children who are most deprived, because it is not well crafted. We understand that it is difficult for any Government to ensure that such methods work.
	The one thing in the Opposition motion that I found difficult to swallow was the mention of ideology. I honestly fail to see what the Government's ideology is. I do not see a consistent theme running through their education policy. There are bits and bobs of ideas, some of them refreshing and interesting, but when it comes to others I, and other people who have been in education for a long time, do not understand where they are coming from or where they are leading us.
	As Chair of the Select Committee for nearly 10 years, I found it refreshing when a Minister came before the Committee and said that the reason for introducing a policy was that it was evidence-based. One of the most refreshing things about Tony Blair in his 1995 conference speech, in his Ruskin speech in 1996 and when he put that speech into operation in 1997, was that he was both pragmatic and open to evidence-based policy. We saw that across a raft of policies, but when the Committee looked at how policies evolved, we found that when Ministers left the evidence base they got into trouble.
	The present Government seem to be basing their whole education policy on something called the big society. Many people have talked to me about what the big society means. It is very difficult to find out. What is the big society? Is it localism? It is a funny sort of localism that jumps over and disregards locally elected education authorities. That is a very different kind of localism.
	How do we know that people who want free schools represent the community? We have already heard evidence that there have been some strange bids. I am not sure that the answers we heard today about faith schools were entirely convincing.

Graham Evans: Before the general election, Labour Members supported co-operative schools. Can the hon. Gentleman tell me the difference between the co-operative schools project and the Government's free schools project?

Barry Sheerman: I was, and am, a great supporter of co-operative partnership in academies. I was a great supporter of academies, but I understood exactly what the argument for academies was under the previous Government. Under Tony Blair, it was to take first 200, and then a further 400, schools where everything else had been tried; they were usually in areas of great deprivation and everything that had been done to try to raise standards had failed. We introduced academies where we thought it was worth trying something because nothing else had worked, but now the academy model has been inverted. It is no longer about where schools are failing and real help is necessary for kids, who get only one chance for education-where we need to act quickly because we cannot wait for a laggardly local authority to get its act together. We now have a system in which any school can become an academy, and I am not sure what its theme, goal or arrival point is.
	The big society does not seem to be a substitute for evidence-based policy, or to involve a clear notion of where we are going with education policy. I shall illustrate that with just one point. My concerns are not only about Sure Start and early years, but also about the fact that there is now seemingly an end to the choice that was opening up. There was real choice in our schools-the apprentice route, the skills route through the diploma, or the academic route. That opening up, with the possibility to cross over, was very refreshing, but it seems to have been killed by the new Government.

Graham Stuart: It is a great pleasure to take part in the debate, although I must express some disappointment with the opening speech by the right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State. It lacked a contribution on how to improve our school system. There were improvements in our education system under the Labour Government; there is no question about that. In general, we have a motivated and high-calibre teaching work force, although of course they too could do with further improvement. There was nothing constructive in the right hon. Gentleman's speech.
	When a party is thrown out after 13 years in government, there is a real opportunity to think again. One of the first things Labour Members should do is put their hands up on some of the issues. For Labour to have presided for 13 years over a widening of the gap between the educational outcomes for rich and poor, and a widening of the gap in the overall educational performance of the UK against its key competitors, is not something about which to be complacent or self-satisfied. Collectively, as a political class-although I was on the Opposition Benches-we failed to turn the vast increase in expenditure on education under the previous Government, and the political will that existed then, into sufficient progress for the poorest in our society-which one would have hoped would be delivered by Labour-and for the country overall.
	Wrestling with the issues of bringing about improvement in our education system is what we should all be involved in, rather than trying to score points, especially as it is likely that the coalition Government and this Parliament will run for some years. Every party, not least the Opposition, should be dealing with the real issues, and should have a platform for improvement.

Jenny Chapman: The hon. Gentleman speaks about the good will of the Opposition and their desire to reduce inequality in education. Is it not true, however, that we do not yet know how successful our expenditure on reducing such inequality might be because, for example, children who started in a Sure Start centre when those first opened in my constituency are not yet 16, so we do not know what choices they will make?

Graham Stuart: The hon. Lady makes a fair point. Many of those initiatives, such as Sure Start, are being supported by this Government. The hon. Member for Nottingham North (Mr Allen) has been an ardent champion of early intervention and has helped Members in all parts of the House to recognise the need to intervene early in order to make sure that children arrive ready for school, and that they have a decent vocabulary so that they can engage with learning. There is merit in what the hon. Lady says, but even the most ardent supporter of the Labour Government would hardly suggest that the improvements that were wished for have genuinely been delivered.
	I am pleased to follow my predecessor, the highly distinguished former Chairman of the Select Committee, the hon. Member for Huddersfield (Mr Sheerman), who said that he could not see an ideological base. I hope it is a practical evidence-based approach by the Government. It is clear that they believe that giving greater trust, responsibility and control to front-line professionals is more likely to lead to an improvement in standards than central prescription, however well-meaning. It is as obvious to me as the River Jordan that that is the key insight of this Government.
	We must ensure that that process is well thought through, that we support front-line professionals, that capability is developed where it does not currently exist, and that it is put in place in time to match any withdrawal of support from local authorities or others who may previously have delivered it.

Jonathan Reynolds: The hon. Gentleman is speaking about the Government's wish to push more resources towards the front line, but in his opening remarks the Secretary of State talked about some of the most intractable areas of poverty and deprivation in the UK. Does the hon. Gentleman believe that directing resources to the front line and reconfiguring budgets alone will solve those problems, or that bigger, bolder schemes such as education maintenance allowances are required to tackle the deep-rooted poverty that causes that deprivation?

Graham Stuart: That, too, is a fair intervention. This is not the Government's sole policy area. They are also considering doubling the size of Teach First over the next three years, and have been in negotiation with Teach First about that. The essence of improving education standards is higher-calibre, better supported, better motivated, better led teachers in the classroom. That is what it is all about. That is the prism through which we should look at every decision that we make-which is why I welcome the Teach First approach.
	It is not necessarily contradictory, though I can see that it may look hypocritical, to talk about reducing central prescription on what teachers may have, on the one hand, and on the other, raising the bar to those whom the state supports to go into teacher training so that the people coming in are better qualified.
	The hon. Member for Stalybridge and Hyde (Jonathan Reynolds) is right to ask those questions. Tools alone will not deliver. What is needed, and what we have heard from head teachers and from the profession over the years, is that too much prescription, too much teaching to the test, too much narrowing of the curriculum-in other words, too much of what want on under the previous Government-took away the joie de vivre and the empowerment of front-line professionals. If we can bring that back, plus Teach First, put the tools in place, encourage ever better school leadership and school governance, which I hope the Select Committee will examine over time, we can move our education system on to a higher plane, and deliver what Members in all parts of the House want.
	Knockabout-trying to suggest that Tories eat babies, or whatever those on the Opposition Front Bench seem to suggest-is not helpful. I believe that everyone in this House, regardless of party, came into politics because they would like to create a more just and fair society. This is not only about social justice. The forces of globalisation, which we cannot stop, and the suggestion in the Leitch report that there will be fewer and fewer jobs for people who do not have skills, make it an absolute economic necessity that we improve the skills of our young people. In response to the hon. Member for Darlington (Mrs Chapman), the truth is that we failed to make the progress that we should have done, and this Government feel that autonomy, plus their other measures, represent a better way to achieve that.
	I want to make some brief remarks about Building Schools for the Future. My predecessor, the hon. Member for Huddersfield, who is chatting at the moment, knows full well that there is not the evidence to show that capital investment in schools leads to educational transformation. There is a link, but it is pretty small. Obviously, we all regret the fact that we cannot have brand-new schools where schools are not in an ideal state, but under BSF the allocation of money was out of proportion to the benefit given. Under this Government, more money will be spent on capital in schools in this Parliament than in the first two Parliaments of the Labour Government. Let us keep this in perspective. We need to recognise that nobody wants children to be in a school that is not in a good condition, but equally there is no evidence to show that the building itself, however inspiring the children may initially say it is when it opens, leads to the educational transformation that is at the real heart of improving outcomes, particularly for the poorest.
	I should like to touch on the education maintenance allowance, which many other Members have mentioned. In the case of the EMA, unlike BSF, there is material evidence to show that it has helped young people from certain backgrounds to stay in education. I hope that Ministers will take that evidence very seriously and ensure that whatever they put in place does not artificially stifle that opportunity for people.
	On the move from the current position to autonomy, we need to consider issues such as school sports trusts. I hope that Ministers, while generally believing in giving autonomy to schools and passing it down, will be careful to ensure that transitional arrangements, and sometimes funding, are in place so that things of value are not unnecessarily lost before they grow again from the grass roots.
	Most of all, what we must have for this country is aspiration-aspiration to raise standards overall, and aspiration in believing that we can do so much better. So far, the shadow Secretary of State has been far more of an expert on health than on education, but I hope that he can start to express that Blairite aspiration of looking upwards, improving and challenging all the time, rather than simply defending the status quo, which is indefensible as it stands.

Stephen Twigg: I am delighted to follow the hon. Member for Beverley and Holderness (Mr Stuart). I welcome the measured tone of his remarks, particularly his final comments on the education maintenance allowance and school sports partnerships.
	It is incumbent on Members in all parts of the House, but particularly Labour Members, to respond to the Secretary of State's challenge on continued inequality in education. It is clearly a scar on our society and our economy that someone's social background is still such a key determinant of how well they will do later on in life. However, I would appreciate it if he would acknowledge the serious efforts that Labour in power made to enact reforms that would make a difference to the situation, not least the academies programme. The Labour version of the academies programme was very much about dealing with deprivation and struggling and failing schools in some of the poorest communities. The record in those academies since they were established over the past decade has been overwhelmingly positive and successful.
	The education maintenance allowance also provides an excellent example of a Labour programme that has made a real difference, with more young people from poorer backgrounds achieving higher qualifications as a result of it and, crucially, more young people from those backgrounds staying on into higher education than happened previously. There is no question of Labour Members abandoning reform, and we now have an opportunity to consider the reforms that best take forward our principles in seeking a more equal society in future.
	I want to address a couple of the specifics in the motion moved by my right hon. Friend the Member for Leigh (Andy Burnham). Labour's record on capital investment is an overwhelmingly positive one. It is a matter of concern that while the average cut in capital investment by Government Departments over the next period in the comprehensive spending review is 28%, the average cut for schools is more than double that, at 60%. That has real implications in constituencies such as mine. Schools that were going to benefit from wave 6 of Building Schools for the Future were let down in the summer and are still waiting to see what will happen in future. Liverpool city council has taken the sensible approach of trying to devise a plan B, and I urge the Secretary of State and his officials to work closely with Liverpool so that we can have such a plan. In the summer he gave an undertaking that he or one of his Ministers would come to Liverpool, and I repeat the invitation so that we can work together to secure the very best capital support for schools in my constituency and across the rest of Liverpool.
	The principle behind the pupil premium is good. There is a genuine problem, which the hon. Member for Mid Dorset and North Poole (Annette Brooke) mentioned, with pockets of deprivation in otherwise affluent areas. Sometimes, local government fails to redistribute funds to ensure that the affected schools get the money that they deserve. Our concern, as my right hon. Friend the shadow Secretary of State set out, is whether the pupil premium is to be additional money, and particularly whether schools in constituencies such as mine will directly lose out as a consequence of its introduction. Liverpool has the highest level of deprivation in England, and we need to ensure that our funding is properly protected so that we can build on the remarkable improvement in standards in Liverpool's schools since 1997.

Ian Murray: My hon. Friend is discussing the pupil premium eloquently. Would he like to comment on a situation in my constituency? During the general election campaign the Liberal Democrat candidate was championing the pupil premium, at the same time as the Liberal Democrat council was closing schools in the most deprived areas.

Stephen Twigg: It is obviously shocking and unprecedented to hear an example of the Liberal Democrats saying one thing in one place and doing the opposite elsewhere. I am certainly very concerned by the example that my hon. Friend gives.
	My concern is that there will be a triple blow for the poorest communities, including the one that I now represent: the loss of capital investment through Building Schools for the Future, potential revenue cuts because of the creation of the pupil premium, and the abolition of the EMA.
	I wish to address two other specific matters in my remaining time. The first is the impact of the Government's decisions on sports, to which my right hon. Friend the shadow Secretary of State referred. There has been fantastic work by the Youth Sport Trust and school sports partnerships in the recent period. Moving away from specialist sports colleges is a fundamental error. It is wrong for the academic chances of the kids who go to those schools, bad for participation in sport and physical education and bad for health and the campaign against obesity.
	In my constituency is the excellent Cardinal Heenan school, which is a specialist sports college. My right hon. Friend will be delighted to hear that it works closely with Everton football club to promote sport and PE not just in that school but in local primary schools. We need to learn from the positive examples of such schools. I recognise that removing ring-fencing can often be popular with schools in principle, but there is always a fear that if we move away from a national strategy and a targeted approach completely, the original objective of that strategy will be lost and we might see a reduction in participation in sport and PE. That would come at a time when, for health reasons, we need more participation, not less.
	My final point is about citizenship education. As a Minister, I was proud to launch that as part of the core national curriculum. I know that the Government are reconsidering the national curriculum, and I should like to make a plea for citizenship to remain a core part of it. Members of all parties can unite in sharing concern about the decline in active involvement in communities and political literacy among young people.
	The evidence suggests that the impact of citizenship education has been patchy, without any doubt, but Ofsted has shown that the best citizenship lessons are those taught by teachers with a specialist subject knowledge. My fear is that if citizenship education ceases to be part of the core national curriculum, fewer teachers will train in it and there will be a decline in its quality in our schools. I hope that the Minister who responds to the debate will be able to provide some reassurance that this Government, like the previous one, see citizenship education as a very important part of the curriculum.
	All parties can agree that education is important for social justice and for our economic future. There is a real fear that the Government's policies could further widen the gap between the deprived and less deprived parts of the country through cuts in capital investment, the loss of the EMA and the impact of the pupil premium. I urge them to think again in those key policy areas.

Karen Lumley: Thank you, Mr. Speaker, for the opportunity to speak in this very important debate. Education is vital not only to the future of our children and young people, but to the future of the UK as a whole. Our economy depends on nurturing the best and brightest talents, and we should ensure that each and every child, no matter their background or social situation, has access to the very best education that we can provide.
	I should like to declare my interest in this debate. I am chairman of governors of Vaynor first school, which is one of the largest first schools in the country with 408 pupils. The Secretary of State may remember visiting Vaynor with me a couple of years ago. Yesterday, I received an e-mail from its head teacher. She wrote:
	"I could kiss Michael Gove! He has cancelled Financial Management Standards in Schools."
	Although it would not be proper for me to echo both sentiments in that statement, I firmly support the Government's move to cancel needless micromanagement. As chairman of governors, I fully understand the issues surrounding fairer funding for our schools. The Government's long-term plans for a simpler funding system are welcome. There is a definite need to tailor funding for schools in each area, not base funding allocation on a complicated and arbitrary system that overlooks local needs.
	There is also a large disparity between the funding allocated to similar schools in different areas of the country. It has not escaped my notice that the constituency of the Leader of the Opposition receives per pupil funding of £4,083; the constituency of the right hon. Member for Southampton, Itchen (Mr Denham) receives per pupil funding of £4,265; and even higher is the guaranteed per pupil funding of £4,317 for the constituency of the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson). Redditch, on the other hand, receives only £3,864. Those right hon. Gentlemen who put forward today's motion receive on average almost £300 more than schools in my Redditch constituency.

Robin Walker: My hon. Friend makes a powerful point on behalf of the schools of Worcestershire. May I add one more statistic to her figures? There is a £760 per pupil gap in funding between pupils in Worcestershire and the neighbouring authority of Birmingham. Her constituency in Redditch and mine in Worcester include some of the most deprived wards in the country. Both were represented by Labour Members in this House for 13 years, and people in those communities were on a 13-year promise of fairer funding. Will my hon. Friend join me in welcoming this Government's intention to review the funding formula? If Opposition Members turn their backs on funding reform, they will be turning their backs on some of the neediest communities in Worcestershire.

Karen Lumley: I agree with my hon. Friend. I urge the Government to ensure that funding is fair and that schools across the country have equal access to the piggy bank. I also welcome the Government's plans for the pupil premium and the £2.5 billion that has been found in these difficult economic times to support educational development of the most disadvantaged pupils. That shows a real commitment by this Government to reduce the attainment gap and ensure that each and every school pupil reaches their potential. However, we must ensure that the pupil premium goes to those who are most in need, and I urge the Government not to overlook the pockets of deprivation that exist in Redditch and Worcester, the constituency of my hon. Friend. Will the Government clarify how the pupil premium will reach those pockets of deprivation?
	Finally, I should like to say a few words about standards in schools. I should like to see standards raised in Redditch over the course of this Parliament. I firmly believe that the Government should focus on school standards-not just in a few schools but in all our schools. We need to ensure that teachers are free from the increasing bureaucracy and incessant form filling so that they can concentrate on teaching our children.
	When I meet teachers and head teachers, one of the first things that they mention is the endless amounts of paperwork that they have to deal with. We need to move away, and stay away, from the bureaucratic procedures imposed on our school system and make sure that it is replaced by teachers spending more time with the pupils. I received another e-mail yesterday, from another head teacher in my constituency, who wrote:
	"Just to say I applaud the Government for abolishing this bureaucratic burden on schools. It is good to finally have a Government that listens".
	On that note, I will finish my contribution. We in Redditch are trying hard to improve our schools and get the very best education for our children. I applaud the Government's proposals and hope that all hon. Members will make their schools and our nation's children their top priority.

Bill Esterson: I welcome the contribution of the hon. Member for Beverley and Holderness (Mr Stuart), the Chair of the Select Committee, and his comments about the importance of investment in improving attainment and standards, but it is also important to recognise that the previous Labour Government not only put in the money but achieved results. I did not recognise the hon. Gentleman's characterisation of what happened. GCSE results and others improved, and there was a big increase in further and higher education results.
	My family was fortunate enough to have access to Sure Start when a centre opened where we lived. It benefited not just my family but the other families who used it. They told me in great detail the difference that it had made to the younger children, when compared with older children who had not had such an opportunity in a Sure Start centre or in any other pioneering family centres that preceded it. The difference can be seen many years later in the attitudes, behaviour and achievement of the younger children, who are now teenagers, compared with their slightly older brothers and sisters, who had no such support in the early years. I know from that evidence the importance of Sure State to children who live in deprived areas, which explains people's concerns about Sure Start's future.
	The Secretary of State did not answer the point that my right hon. Friend the Member for Leigh (Andy Burnham) made about concerns regarding the future of Sure Start, but perhaps he will do so in his closing remarks. I know from my experience and that of many others who have benefited that, of all the previous Government's achievements, the improvement in the quality of lives and the outcomes for children and families, just through Sure Start, is beyond measure.
	The education maintenance allowance benefited many young people who stayed in education. Indeed, the Liberal Democrats suggested in their manifesto that they understood that. They promised to support the EMA, as did the Conservatives, because they saw the improvement in staying-on rates, and the predicted decline by some organisations in staying on of 10% or 12% is worrying. In Sefton, 80% of young people receive EMA, and from talking to them I know the number who say that they will not bother going to college any more without the £30 or £50 a week is frightening. I hope the Government reconsider the limits they are placing on support to young people.
	Earlier, I asked the Secretary of State about the pupil premium, about which the Institute for Fiscal Studies and the Library make similar points. The rise in the numbers of children going to school means that, despite the pupil premium and the increase in the overall money for schools, the real terms effect is a cut for 87% of secondary schools and 60% of primary schools. That cannot be what the Secretary of State intended, and the impact on areas of deprivation, to which the hon. Member for Redditch (Karen Lumley) referred, is worrying.
	I accept that we need to look after people in pockets of deprivation in the more affluent areas, but it is important to ensure that people in the larger areas of deprivation, such as those in Merseyside and our other large cities, are protected. Unless we do that, the outcomes and many other aspects of life for children who most need our help will decline significantly.

Graham Evans: My constituency is on the periphery of Merseyside and Cheshire. I want to address the needs of those in pockets of social deprivation, which you have just brushed aside. Those numbers add up. I appreciate, and have a lot of sympathy with, the issues that you have in Merseyside-indeed, I support your case-but you cannot ignore those numbers because when you put them into the comprehensive-

Mr Speaker: Order. First, the hon. Gentleman should not, by now, be using the word "you". Secondly, interventions should be brief, not mini-speeches. Other Members are waiting to contribute to the debate.

Bill Esterson: I shall close by addressing that point. I did say it is important that we look after those in pockets of deprivation, but it is crucial issue that we do not do so at the expense of much larger areas where, historically, we have had to invest money to support people because of the extreme deprivation.

Eric Ollerenshaw: Like others, I declare an interest. I was, until 2000, a teacher, having taught in three state comprehensive schools, two of which were classed as social priority. I was a member of the Inner London education authority, the mention of which calls to mind not only political battles of the past but, perhaps, the importance of those battles in changing education structures and of what that can do to raise standards.
	I want to cover three points: spending, teaching in deprived areas and ideology. Although the Labour party does not like it, the sad truth is, as the Secretary of State underlined, that for the next couple of years everything that we do must be seen in the context of the financial mess we have been left with-not only the huge budget deficit and the record national debt, but the fact that Labour went into the last election with blank cheques, of which, for me, Building Schools for the Future was the last. Those are Labour's legacies, and, although today we have been told that we are making cuts, they were phantom legacies with no money to back them up. I congratulate the Secretary of State on what he achieved in the comprehensive spending review-the increase of £3.6 billion over the next four years and the pupil premium, which other Members have mentioned.
	On Building Schools for the Future, we accept that in certain areas there is obviously worry and panic, but the Labour party's suggestion that the capital programme has entirely disappeared and there will be no repairs to schools and no new schools built is a fallacy. In Fleetwood, which has an extremely good Conservative county council that looks after its money, seven primary schools in some of the most deprived areas in my constituency will have been rebuilt and refurbished by the end of this financial year. That work is still going on, whatever Labour claims.
	For me, the learning environment is not just about teaching. It is more than bricks and mortar and, these days, steel and glass. We need quality teaching, good leadership from heads and legislation that allows professionals the freedom to innovate and get on with what they do best.
	I remember starting out as a young teacher-we were all young once-in the 1970s when there was another "building schools for the future" programme under a Prime Minister called Jim Callaghan. My first teaching post was in Tottenham, a deprived area then and now, which is perhaps a comment on a series of Governments in between. One could not imagine this today, but we were offered a purpose-built comprehensive for 11 to 18-year-olds, with eight-form entry, on a brand-new site behind Spurs football club. Northumberland Park school, as it was called, was designed by the latest 1970s architects-hon. Members can imagine the result-and had a theatre and a swimming pool. We moved into the school with its first first-years-we had first-years in those days; I think they are called year 7s now-and a bunch of new, enthusiastic and excited teachers. That is where I learned my trade as a history teacher, and I have three anecdotes about my experience.
	First, 10 years down the line, that school was in serious trouble, so the building was not the problem. Secondly, I was asked, as a history teacher, to choose the European A-level module, and I chose France and Louis XIV because that is what I knew, it was my specialism, and I could bring my best talents to bear on it. However, there was stiff opposition from the so-called education advisers. This is when I tuned into politics, because that opposition was all about questioning the ability of children in Tottenham, whatever their background, to achieve what other schoolchildren could achieve. I was sorry to hear the shadow Secretary of State's comment about teaching Latin in Acton. Why should every child not get the best that other schools-even independent schools-provide? I can tell him that the students who studied Louis XIV have ended up in good jobs because they were well taught, not just by me, but by others.
	My third anecdote is about social deprivation and poor schools. In that same school, I wanted to put on extra classes when we first had a sixth form, and I did so, for children going for their pre-university application. They were the first from that school to do so, but I was told by the local National Union of Teachers activist that I should perhaps not put on extra classes. Why? Because the school might expect other staff to do the same. I was naive enough to believe that getting a job in a socially deprived area and school involved going the extra mile. Through his reforms, the Secretary of State is attempting to allow teachers who are perhaps a bit younger than I am now to go that extra mile and to achieve for every single child.

Nicholas Dakin: It is a pleasure to follow the hon. Member for Lancaster and Fleetwood (Eric Ollerenshaw), who drew on his experience at the chalk face to make his points. I agree with him that every child ought to have the best.
	I have been privileged to spend my life in education, working with the most fantastic young people in schools and colleges as well as with wonderful fellow professionals. Professionals have not always got it right, nor have politicians. However, when the former Prime Minister, Tony Blair, said that his priorities were "education, education, education" he at least put his money where his mouth was. We saw investment in education at all levels-from Sure Start to higher education-the like of which I had not seen in my lifetime.
	That is why the Secretary of State was right to begin his speech by celebrating successful school leaders who prospered under the previous Government. That does not mean the previous Government got everything right, because they could have done some things better, but, sadly, this Government, rather than learning from and building on the success of their predecessor, are doing what politicians too often do: gambling on organisational change. They are starting again with structures, but that is a distraction from the core issues of the quality and teaching and learning, and the capacity and quality of leadership in schools and colleges, which the hon. Member for Beverley and Holderness (Mr Stuart) rightly emphasised.
	Nationally, schools with the highest number of children who receive free school meals have seen the biggest rise in educational attainment. There has been phenomenal investment in information technology and other modern equipment in our schools, and the role of support staff has been transformed so that the focus is more effectively on the needs of our young people. Teachers are now specialised in teaching and learning, and the outcomes that they have achieved at all levels of our education system have improved year on year. Exciting and innovative things are happening in our comprehensive classrooms, yet, at the very moment when there is a momentum towards greater success, what do this new Government do? With no electoral mandate, they decide to turn everything upside down and gamble with our children's future.
	We need look no further than the Government's approach to EMA to see how they have strayed from their mandate and gambled with our young people's futures. Over the past few years, EMAs have been a spur to widen achievement and raise aspiration. My right hon. Friend the Member for Leigh (Andy Burnham) quite rightly quoted the Secretary of State when, putting our right hon. Friend the Member for Morley and Outwood (Ed Balls) in his place, he said, "I have never said we are scrapping EMAs. We won't." It was pleasing to see that the Minister of State, the hon. Member for Bognor Regis and Littlehampton (Mr Gibb) said as recently as June:
	"The Government are committed to retaining the educational maintenance allowance".-[ Official Report, 14 June 2010; Vol. 511, c. 307W.]
	Sadly, we now know that not only is a pledge not a pledge, but a commitment is nothing more than a throwaway line.
	Research conducted by CfBT-the Centre for British Teachers-gives robust evidence that EMAs have increased participation and achievement among 16 and 17-year-olds and contributed to improved motivation and performance. As the hon. Member for Beverley and Holderness recognised, when effectively focused on the target groups, EMAs are restricted to low-income households and disproportionately taken up by those with low achievement at school, those from ethnic minorities and those from single-parent families. Research by the Institute for Fiscal Studies shows that attainment at GCSE and A-level by recipients of EMAs has risen by 5 to 7 percentage points since their introduction.
	I know all that from my own experience as the principal of a sixth-form college. Indeed, only this week the principal of North Lindsey college in my constituency wrote to me expressing alarm at the impact of the Government's plans to scrap EMAs on young people's aspirations. He urged me to raise the matter in Parliament and to argue the case for retaining EMAs, so that is what I am doing this evening. I am appalled by the way in which the Government have abandoned EMAs, breaking the promises that they made to young people as recently as June, as well as before the election. As my right hon. Friend the Member for Leigh pointed out, this Government are taking a reckless gamble with our children's futures.
	Sure Start is being reduced and diminished. The pupil premium appears to mean no more than raiding money from other pots and distributing it in a different way-a way that may turn out to be more unfair. That is why a Liberal Democrat colleague-the hon. Member for Bradford East (Mr Ward)-left the Chamber so peremptorily earlier on. He was not satisfied with the answer that the Secretary of State gave to his quite proper question. There will be a real-terms cut per pupil in the schools budget. BSF is a shambles, with schools, communities and students being let down. Support for school sport is being dismantled, thereby betraying our commitment to an Olympic legacy. EMAs are being cancelled and tuition fees trebled. So much for aspiration.
	This is a casino Government, gambling with the economy, gambling with our nation's health service and gambling with our children's future. It is a gamble that is uncosted, unhelpful and unnecessary. I urge all hon. Members to support the motion before the House this evening.

Rob Wilson: The Opposition's motion today accuses the Government of
	"pursuing a reform agenda in education that represents an ideological gamble with successful services"
	but Labour needs to acknowledge all its past, if it is to be taken seriously on education in future.
	In my constituency, after 13 years of a Labour Government and a Labour council, and with two Labour MPs between 1997 and 2005, the latest local figures available show that nearly 40% of pupils fail to achieve the basic standard of five good GCSEs, including maths and English. The national figures show that nearly half of all pupils failed to meet that basic standard last year. I am therefore not sure how those on the Labour Front Bench can claim any success, especially when so many thousands of young people are leaving compulsory education without achieving even the most basic of standards. Nor can they claim that the issue is expenditure. In real terms, public expenditure on education increased by £35 billion over Labour's 13-year period in office, which is an increase of some 72%, although the increase in my constituency was only 50%. Essentially, 50% of children are failing to reach the basic standard, and that is as good as it got in 13 years of a Labour Government. The minor improvements that took place in later years-the introduction of academies, and things like that-were unfortunately far too little and far too late, leaving many children failing in our schools.
	Although there are still too many bad teachers in our schools, a large majority are committed and doing a wonderful job in very difficult circumstances. As with so many other parts of the public sector, teachers have been tied up with bureaucracy, and constrained by an over-supply of rules and an under-supply of common sense. I see that week in, week out in schools in my constituency, and I therefore welcome the fact that my Government are introducing truly radical reforms to increase innovation and diversity of approach in our schools. After years of failure by a Labour-run council, I welcome the fact that the Government's academy policy is handing powers to the people who are best placed to understand the needs of education in their local areas: teachers, head teachers and governors.
	In my constituency, there has been a stampede to academy status. Highdown school has already announced its intention to gain such status, and Reading boys school and Kendrick girls school, both grammar schools, will follow shortly. I am sure that others, such as Reading girls school, will take advantage of today's announcement by my right hon. Friend that any school may now apply for academy status if it teams up with a stronger school that will help to drive improvement.

Alok Sharma: In addition to welcoming the success of the academies in my hon. Friend's constituency, does he also welcome, as I do, the Secretary of State's recent decision to allow the National Education Trust, the Centre for British Teachers and the Friends of All Saints school to move forward to the next stage of setting up a free school in my constituency with the aim of opening a 120-pupil school in September next year? That local school is backed by local people and the whole of the local community.

Rob Wilson: Of course I welcome that. My hon. Friend has done a great deal to help that process.
	I want to make one further remark about my two excellent grammar schools, and I say this gently. I have had conversations with head teachers to the same end. Their catchment areas need to be looked at carefully. Kendrick school in particular is recruiting pupils from far and wide, and is becoming too remote from the local community that it serves. I would like my local grammar schools to re-engage with the task of aiding social mobility for clever, poorer local Reading children rather than being regional schools. I hope that my right hon. Friend will ensure that those schools can expand their numbers to recruit more local Reading children as that may help the situation.
	My right hon. Friend will be aware that under the last Government, grammar schools were, unfairly, not allowed to expand their numbers. It is clear that people in my constituency are voting with their feet, and schools are taking advantage of academy status and all the freedom that that brings, instead of staying with the failed system of central planning of the shadow Secretary of State's Government.
	I hope that very soon there will be another massive step forward for education in my constituency with the announcement of a brand new school. I have been particularly taken with the success of city technology colleges and university technical colleges to support education for 14 to 19-year-olds. They would add real diversity and choice for parents in my constituency.
	Before it was popular and before it was Conservative party policy, I often wrote about and campaigned for a pupil premium. It is gratifying that the Government are implementing such an important and radical policy, which could see some schools with a particularly high concentration of poor pupils receive as much as £1 million in additional funding to deal with the particular disadvantages associated with poorer pupils. That could make an enormous difference, and help to close the attainment gap between rich and poor pupils, although I accept that on its own it will not be enough.
	The Opposition should recognise that the coalition Government are taking on the most successful policies of the last Government, such as the Teach First scheme to bring outstanding graduates into teaching. But they must also face up to the reality that 13 years of a Labour Government and local authority-run education services have left a legacy where, despite massive investment, almost half of pupils fail to make the best or even the most basic grade at school. We owe it to our children to try radical new approaches that have had great success both here and in other countries. It is time to break the cycle of under-achievement.

Pat Glass: I realise that time is short, so I have cut down enormously on what I was going to say. I shall stick to the main points. I have been privileged to spend most of my career in education. I know how schools operate, unlike most of those on the Government Front Bench, and I am therefore in the privileged position of being able to comment on the Government's proposals and on how they are likely to impact on schools and on outcomes for children.
	Given my background, I will always approach education reforms not from an ideological standpoint but from the standpoint of whether they will improve schools and outcomes for children, especially poor and vulnerable children, and those with additional difficulties, in constituencies such as mine. The question for me is whether the Government's reforms will continue the many different improvements that we have seen, or whether they will act as an anchor on talent and aptitude.
	I find it inconceivable that any Government could consider allowing just about anyone to open a free school in any type of building, without outdoor play areas, recreational space, or qualified teachers. I am sure the Secretary of State will be aware of the recent Institute of Education report, which clearly demonstrates that the more time a child spends with a support assistant, as opposed to a teacher, the less progress that child will make. It is the strength of the pedagogical environment, the specialist knowledge of the subject and the confidence and quality of the teaching experience that deliver progress. That can only come from a qualified teacher working in a qualified environment.

Andrew Turner: Will the hon. Lady give way?

Pat Glass: I am sorry, but we have very little time.
	The Government are proposing a relaxation of the accountability framework in schools, so that academies and schools judged to be outstanding will be inspected only every seven years. I have to ask whether that is going to improve outcomes for schools. I have many criticisms of Ofsted, but I do not criticise its relentless pursuit of an upward trajectory in school improvement. We are all swiftest when we are chased, and that applies as much to head teachers, teachers and schools as to anything or anyone else.
	The Government are seeking to abolish independent appeals panels for exclusions. I understand from my discussions with schools that that is not what they want. Head teachers and chairs of governing bodies are telling me that, while it can be very uncomfortable to appear before those independent panels, they provide valuable checks and balances in the system. The heads and chairs are concerned that, without them, they could find themselves defending their actions in court. That would not be good for schools.
	The Government are also proposing a national funding formula that is distributed from central Government. However, I am more concerned with what that resource will drive into schools than with where it comes from or who delivers it. The Prime Minister and the Secretary of State have repeatedly said that they will protect schools funding, but when asked direct questions, they have given very few direct answers. I was pleased to hear the Minister of State, Department for Education, the hon. Member for Bognor Regis and Littlehampton (Mr Gibb) advise the Education Select Committee this morning that schools budgets would grow by subsuming the standards fund and the educational needs grant into the baseline, and that they would be increased by the pupil premium. If that is true, it is welcome. However, the Secretary of State needs to know that I will be checking out the position with schools in my constituency when they get their budgets in December, and if those schools, which educate some of the most deprived children in the country, have less money next year than they have this year, I will be his worst nightmare.
	The Secretary of State is an English graduate, and he is fond of coming to the House and lecturing us on the teaching of history. I want to give him a lesson from my end of the curriculum. Unlike politics and philosophy, maths is an absolute science. I shall start with an easy equation. If schools in the poorest communities receive less funding next year than they did this year, and if we add that to more unemployment and poverty as a result of Government cuts, that will equal poorer standards and outcomes, not better ones.
	I have looked at the reforms very carefully, and if they are going to produce better outcomes for schools, I will welcome them. However, it is my considered view that they will lead to improved outcomes for some children but poorer outcomes for most. The strap-line of this Government will be less "Every child matters" and more "Actually, some children don't matter very much at all". That would be a tragedy for the majority of children and schools in this country. The Government appear to be following an ideological experiment with other people's children, and it is the poorest and the most vulnerable who will lose out most.

Several hon. Members: rose -

Nigel Evans: Order. The next speaker will be Damian Hinds. I ask him to sit down at 6.40 pm.

Damian Hinds: Thank you, Mr Deputy Speaker, and I appreciate that we are running on a somewhat reduced timetable, but I want to spend a little time metaphorically to reach across the Floor, if I may, and express some sympathy for the fact that Labour was the party that Opposition Members joined.  [Interruption.] Most Labour Members may not have been on the Front-Bench team or even in this House during the previous Labour Government, but this is the party they joined and they looked to it to be progressive and ambitious for every child in this country. I am sure they still do, but when they look back on the 13 years of Labour Government, they will see our decline in the international league tables and a widening gap on social mobility, not to mention the 900,000 young people not in education, employment or training. They must be disappointed. The real disappointment, however, is that when faced with a bold and truly ambitious programme such as the one put forward by my right hon. Friend the Secretary of State, those on the Labour Front Bench have nothing positive to say.

Ian Mearns: rose -

Damian Hinds: I would love to give way, but given the tight timetable, I am strongly advised not to-I apologise.
	Far from being the ideological gamble suggested by the right hon. Member for Leigh (Andy Burnham) in the Opposition motion, I believe that our programme of change is measured, responsible and genuinely based on evidence. One refreshing aspect of the new Government is that whenever discussion of education policy arises, it always starts with the international evidence and considers where in the world something is done best-whether it be in Norway, Sweden, parts of the United States, or Singapore. Further confirmation of the coalition Government's evidence-based approach is that they have not proceeded in an ideological way, as they have continued a number of programmes put forward by the previous Government. They are even continuing with some policy elements that have not yet started or are only just beginning, such as, for example, increasing the participation age to 18 or the extension of free entitlement in early years. That, if nothing else, provides absolute evidence that our approach to education is not about salami slicing, cheese paring or any other kind of food cutting-up that could be described.
	There are good and great things happening in any period, and some occurred under the last Labour Government. I am thinking of the academy programme, in particular, which was the baby of the former Prime Minister, Tony Blair. The former Chairman of the education Select Committee, the hon. Member for Huddersfield (Mr Sheerman) said that he understood the approach towards the first wave of schools in the academy programme under the last Government, but it was always Tony Blair's ambition that, eventually, to use his own words, "every school" could be an academy.
	The new coalition programme is about focusing on the elements that can make the most difference, prioritising the areas, the people and the children that most need help at the most pivotal times in their lives, and then trusting professionals to get on and do the job. When it comes to spending money where it can make the most difference, I believe in people, not palaces. Of course the school environment makes a difference, but what makes an even bigger difference is the person standing at the front of the class-the person who can inspire and lead those young people, helping them to learn. That is why I welcome the extension of Teach First, the introduction of Teach Now and new initiatives such as Troops to Teachers.
	It is often said that no one forgets a good teacher, but I have met many people who have forgotten a good smart board. In the Building Schools for the Future programme, the £1,625 spent per pupil on IT would have been much better spent in investing in our human resources and our people.
	As to focusing on the people who need help most, there is the pupil premium, supplemented by the education endowment fund. Although it is right to debate how that formula works and how the transition to the pupil premium will work, I would love to hear any Labour Member challenge the principle of the pupil premium and say that it is the wrong way to go about funding education. There should be an amount per pupil and then a supplement- [Interruption.] I am talking about the structure. The supplement will go to those who need it most. It puts the money where it is most needed and it will incentivise schools to take on the most needy pupils rather than have the top-skimming about which people rightly complain.
	I have virtually no time left so I shall conclude by saying that focus on the most formative times is important. That is why I particularly welcome the extension of the early-years free allowance and the extension to the neediest children at age two. Every piece of academic evidence that I have ever seen says that it is most important to focus on the very earliest years to help with children's futures. That will affect their ability to read and their behaviour and discipline, which affects all those around them.
	We thus have diversity and choice in respect of school types and we have progressivity in respect of the pupil premium and other measures. We also have an evidence-based, financially responsible approach that will allow more schools to prosper, more teachers to flourish and more children to become everything they possibly can be.

Kevin Brennan: We have had a very good debate, which has included contributions from my hon. Friend the Member for Huddersfield (Mr Sheerman), the hon. Member for Beverley and Holderness (Mr Stuart), my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg), the hon. Member for Redditch (Karen Lumley), my hon. Friend the Member for Sefton Central (Bill Esterson), the hon. Member for Lancaster and Fleetwood (Eric Ollerenshaw), my hon. Friend the Member for Scunthorpe (Nic Dakin), the hon. Member for Reading East (Mr Wilson), my hon. Friend the Member for North West Durham (Pat Glass) and the hon. Member for East Hampshire (Damian Hinds). The debate has been well informed, with Back Benchers in particular bringing their expertise to the subject.
	The Government are embarking on an ideological experiment with the children of this country. Let us look at some of the measures that have been discussed this afternoon. The pupil premium has featured quite largely. It is supposed to be the Liberal Democrats' flagship contribution to the coalition Government, so important that any funding for it would be in addition to planned spending on schools. That is what the right hon. Member for Yeovil (Mr Laws) said was the benchmark, and that is what the Prime Minister said. He said that it would be additional. That is what a premium is, after all: something on top. Then along came George, and the Treasury boffins.
	I know that the Secretary of State is a very cultured man. I would say that he is a very literary man. Some might say that he is sometimes a self-dramatising man. However, no one would ever be so vulgar as to suggest that he is a man with an eye for detail, or with his finger firmly on the figures. How else can we explain the fact that he was popping open the champagne when he received his settlement from the Chancellor of the Exchequer, despite having just been done up like a kipper?
	Let me give the Secretary of State some advice. If the Chancellor offers the same amount of cash next year as this year, that is a cut in real terms. If he then offers to top it up so that, per pupil, it does not keep up with cost increases over the next few years, that is not a pupil premium, but a real cut per pupil. It is not a pupil premium, but an old Treasury con. The Secretary of State should have known better.

Dan Rogerson: Will the hon. Gentleman give way?

Kevin Brennan: I have not enough time, I am afraid. Well, I might give way in a minute.
	One can accept that the Secretary of State, with his challenged grasp of numbers, might be beguiled by the Chancellor, with all his confusing charts and tables-that is perfectly possible-but how can we explain the reaction of his Liberal Democrat chum in the Department? How does the Minister of State, the hon. Member for Brent Central (Sarah Teather), respond to this absorption of the supposedly additional flagship pupil premium into a schools budget that has been reduced per head in real terms? Answer: she brags about it. She will have trouble bragging about it when she starts trying to explain to head teachers in Brent Central why their budgets have been cut despite the introduction of the so-called pupil premium. She will have to use all the expertise that she has built up over the years in preparing dodgy bar graphs for Liberal Democrat focus leaflets.
	We can all imagine the scene. Brent head teacher: "But my budget has gone down! Where is the pupil premium?" The hon. Member for Brent Central: "Let me just show you this bar graph. It clearly demonstrates that although you have less money, you have more money than you would have had if we had cut the budget more deeply. You have therefore benefited from the pupil premium." Brent Head Teacher: "Oh, well, that's all right then." Come off it! The hon. Lady must think that head teachers in her constituency were born yesterday. It is a con. When the final budget figures land on head teachers' desks across the country, it will take more than a few dodgy bar graphs from the hon. Lady and a few flowery flourishes from the Secretary of State to con professional school leaders into swallowing this nonsense.
	It is no wonder the hon. Member for Bradford East (Mr Ward) walked out when the Secretary of State admitted that this was simply an increase in cash terms. [Hon. Members: "Stormed out!"] Stormed out, indeed. According to the hon. Gentleman's website, he fights for schools in his area. I believe it, after his reaction to the Secretary of State's announcement to the House. I know that the Minister who will be winding up the debate loves a bit of poetry, so I will give him some Yeats. It was a case of
	"I will arise and go now"
	when the hon. Member for Bradford East heard what the Secretary of State had to say.

Dan Rogerson: rose-

Graham Stuart: rose-

Kevin Brennan: I will give way to the Chairman of the Education Committee.

Graham Stuart: I am grateful to the hon. Gentleman for giving way in what is a witty and well-presented speech, although he is using paltry facts to great effect. The truth is that with funding for the NHS protected-unlike under Labour-along with funding for international aid, the threat to education was significant. People were talking about cuts of 10%, 20% and possibly higher than that. Therefore it must be seen as a good result that, in an extremely tough overall financial round, the education and schools budget, including the pupil premium, is being increased in real terms.

Kevin Brennan: The hon. Gentleman knows that it is not increasing in real terms per head over the next few years, but that is not the point. I would accept that if that were the Government's explanation for what they are trying to do, but they are trying to con people into believing that the pupil premium is truly a premium, an additional sum of money. That is what they promised; that is what the Prime Minister promised, but it is not what is being delivered.
	What else do the Lib Dems get out of this?

Dan Rogerson: Will the hon. Gentleman give way?

Kevin Brennan: I have not got much time, but I might give way before the end of my speech if the hon. Gentleman is lucky.
	What else do the Lib Dems get out of this deal? They get free schools that bypass local democracy, which they used to be so keen on, and that can be set up without any planning permission. They can be set up in an undertaker's if that is what people want, which would make for an interesting school run. The Lib Dems also get a 60% cut in the capital programme, with resources diverted to the Conservatives' peripheral ideological experiment, and a systematic dismantling of any system or programme that promotes collaboration and working together within the family of schools. No school is an island. Yes, by all means give schools freedom and autonomy from unnecessary bureaucracy, but let us please acknowledge that, without any structure for co-operation, standards ultimately suffer.
	Let us look at school sports partnerships, which were mentioned in the debate. This morning at a meeting in the House of Commons we heard from Jo Phillips, a school sports co-ordinator in the Prime Minister's Witney constituency, who is about to be made redundant by the Secretary of State. Along with others, she described the transformation that school sports partnerships have brought in Oxfordshire and across the country. She absolutely dismissed the guff we heard from the Under-Secretary of State at Education questions on Monday, and said she could not believe that the Prime Minister could possibly have been told what the full consequences of the complete withdrawal of funding would be for his constituency and the country as a whole.
	I hope the Secretary of State has explained to the Prime Minister what he is doing with school sports partnerships. We all saw his dramatic transformation from Dr Jekyll to Mr Hyde when the Prime Minister walked into the Chamber in the middle of Education questions on Monday, so powerful was his zeal to please his boss. Perhaps the Government were a bit hasty in getting rid of those relaxation pods they lampooned before they came into office, because the Secretary of State looked badly in need of a place for a nice lie down at the time. I hope he has explained to the Prime Minister that, for the sake of funding a peripheral ideological programme, he has cut a system that has enjoyed near-universal support among teachers, sports people, parents and pupils, and that has transformed pupils' lives-and that he did so on a day when the International Olympic Committee was visiting London means he has also greatly endangered Britain's Olympic legacy.

Dan Rogerson: rose -

Kevin Brennan: I will briefly give way to the hon. Gentleman before concluding my speech.

Dan Rogerson: I am grateful to the hon. Gentleman for giving way. Along with his colleague the hon. Member for North West Durham (Pat Glass), he might want to stay behind for some extra tuition about how to square the cuts proposed by the former Chancellor, the right hon. Member for Edinburgh South West (Mr Darling), with the situation that all Departments would be facing had Labour got back into office, unlike what we have secured in this coalition, which will be extra money for education.

Kevin Brennan: If the hon. Gentleman examines the record, I think he will find that when his party colleague, the right hon. Member for Yeovil (Mr Laws), was discussing this with the previous Education Secretary, the schools budget had been protected and the right hon. Gentleman refused to do a deal because he claimed the Conservatives had already protected that sum of money for schools and he could get a pupil premium on top. As I said, stitched up like a kipper.
	Much progress has been made since the days when I, like many other hon. Members, taught in leaky portakabins under the Tories. A lot of progress has been made since those days of inadequate facilities, inadequate resources and inadequate pay for teachers. The Government seem determined to take us back to a fragmented, underfunded future. They should change course now.

John Hayes: I thank all hon. Members who have spoken in this interesting and timely discussion. The shadow Secretary of State began it and I listened to him with some sympathy, because it is not easy to bounce back from coming last of the serious candidates in one's party's leadership election-I exclude the hon. Member for Hackney North and Stoke Newington (Ms Abbott) for obvious reasons. The right hon. Gentleman may be a loser, but he is a trier and a trier deserves a hearing in this House. He said that the Government are ideological in their pursuit of excellence, and that was repeated by the hon. Member for Cardiff West (Kevin Brennan). If that is the charge-that we are resolute in our determination and unstinting in our efforts to do the best by our children-I, for one, plead guilty.
	The right hon. Gentleman also complained about capital funding so let us put the record straight on that. The level of Department for Education capital funding for the next four years is by no means low. The Department's average capital budget over the forthcoming period will be higher than any single year's figure before 2004-05. Yes this was a tough spending round, but he knows that he is comparing these figures against an exceptional year and that in fact they are higher than the ones for any period during the first term of the Labour Government from 1997.

Andy Burnham: Can the Minister offer us one word of convincing explanation as to why, in a spending review when we were told that schools were protected, the Department got a minus 60% capital settlement when the average for the rest of government was minus 30%? Why were schools singled out for double punishment?

John Hayes: The right hon. Gentleman was not listening to the argument. The truth of the matter is that the capital deal secured by the Department is tough compared with the previous year, but it is by no means exceptional when one examines capital spending over the lifetime of the Government of whom he was a part. Let us also deal with this issue of revenue spending. He knows that combined the pupil premium and school funding, which is protected, means an increase in funding for the schools budget of £3.6 billion in cash terms by the end of the spending review period, which is a 0.1% real-terms increase in each year of the spending review.

Kevin Brennan: Can the Minister just give us the per pupil figure, as he has given us all those other figures?

John Hayes: The hon. Gentleman knows that we are protecting school funding in the system. I am talking about flat cash per pupil before adding the pupil premium. He knows what flat cash per pupil means. It means that as the number of pupils increases, the overall budget increases in line.
	The right hon. Gentleman mentioned the education maintenance allowance, so let us get to the bottom of that. I have the research here, although I know he has not read it. It clearly shows that the EMA did increase participation at the margin: 90% of pupils in receipt of it said that they would have participated in education regardless of the EMA. We are going to target resources more effectively at disadvantage. We are going to help people the previous Government failed to help. I do not need to take any lessons from the right hon. Gentleman-Cambridge-educated and pulled up on the shirt-tails of Lord Mandelson and Mr Blair-about what it is like to move from a council estate to a decent education to this place. When he lectures us-

Clive Efford: rose -

John Hayes: It could be a council estate in Eltham; I give way to the hon. Gentleman.

Clive Efford: I recommended an amendment to our education legislation on the pupil premium and the then Government did not accept it, but nor did I have the support of the Liberal Democrats at that time. The pupil premium was meant to be additional. In addition, it was meant to follow the pupil, which would mean that even schools in affluent areas could take pupils that need additional help and get additional money. That is not what the Minister is offering.

John Hayes: That is exactly what we are doing. The three things mentioned by the hon. Gentleman are all part of the pupil premium: it is additional, it is targeted at the pupil and it allows the local discretion that he cites. The hon. Gentleman's amendment was not supported by those on his Front Bench-it was not supported by those who were in government and who had power over these things when they were prepared to let the dead-weight cost of the EMA disadvantage learners across the country.
	I welcome the opportunity to debate these matters, because the Government understand that it is time for fresh thinking. As my right hon. Friend the Secretary of State said, young people's education today will have a profound social, economic and cultural impact on what Britain becomes tomorrow. A person's learning, however, does not-indeed, must not-end with their compulsory schooling. Much of what has been said by my right hon. Friend the Secretary of State and other hon. Members resonates with the Government's agenda for further education.
	I have just returned from the Association of Colleges conference where yesterday we launched a new strategy for skills that sets out a profoundly optimistic vision for the future of further education and practical learning. I know that the hon. Member for Scunthorpe (Nic Dakin) will welcome that positive approach to practical learning: from the burning fire of ambition to the warm glow of achievement, a future nurtured by professional guidance from an all-age careers service with clear routes for progression; a future for colleges in which their primary responsibility and accountability will be to their learners; and a future in which colleges are free to meet the needs of learners, building confidently on what has been achieved by a better, fairer schools system driven by learners' needs and teachers' skills with standards raised ever higher through diversity and choice.
	That is why we are pushing ahead with opening more academies, including, for the first time, primary academies. A record 144 academies have opened so far during this academic year and there are many more to come. That is indeed record progress-it took four years for the first 27 academies to open. We know that academies are working, as results continue to rise faster than the national average. As my hon. Friend the Member for East Hampshire (Damian Hinds) told the House, academies, specialist schools and other reforms across the world have shown that giving schools autonomy and allowing teachers and head teachers, rather than politicians and bureaucrats, to control schools is what drives up performance.
	The early focus has been on outstanding schools, as we want the best schools to lead by example, sharing best practice and working with other schools to bring about sustained improvements to all schools in their area. We will do much more in our determination to tackle the problem of endemic disadvantage that we inherited from Labour. Our pupil premium will rise progressively to £2.5 billion by 2014-15, supporting the attainment of disadvantaged pupils and incentivising good schools to take on pupils from more disadvantaged backgrounds. The pupil premium will target extra funding specifically at the most deprived pupils to enable them to receive the support they need to reach their potential and to help schools to reduce inequalities, as the hon. Member for Liverpool, West Derby (Stephen Twigg) urged us to do.
	We trust schools to make good decisions about how to spend the money to support deprived children and to narrow attainment gaps, and we need to, because the gaps that we inherited from the previous Government-the widening gap between rich and poor and the failure to address social mobility-were shocking. They were a damning indictment of that Administration and of the people sitting on the shadow Treasury Bench.
	I respect all Members who contributed to this debate. I respect the experience of the hon. Member for Huddersfield (Mr Sheerman), the knowledge of my hon. Friend the Member for Redditch (Karen Lumley) and the concern of my hon. Friend the Member for Reading East (Mr Wilson). I know that people across the House want the best for our future and for our children. However, although some Opposition Members have woken up to the truth that the way to get the best is to put power in the hands of the teachers and to drive the system through the needs of learners, some are wedded to a failed past orthodoxy and we heard it again tonight. I hope that, as my right hon. Friend the Secretary of State said, the right hon. Member for Leigh (Andy Burnham) is not one of those who will defend the failures of the past. I hope that he will embrace reform and that he will come on the journey with us to a better schools system and a better future for our young people. I do not say that all those on the Opposition Benches are without heart. No party has a monopoly on concern or compassion, so I do not say that Labour Members are heartless-I say that their Front Benchers are witless.

Alan Campbell: claimed to move the closure (Standing Order No.  36 ).

Question put forthwith, That the Question be now put.
	 Question agreed  to .
	 Main Question accordingly put.
	 The House divided: Ayes 223, Noes 312.

Question accordingly negatived.

Northern Ireland

Nigel Evans: With the leave of the House, we shall take the two motions on Northern Ireland together.

Hugo Swire: I beg to move,
	That the draft Local Elections (Northern Ireland) Order 2010, which was laid before this House on 25 October, be approved.

Mr Deputy Speaker: With this we shall take the following motion:
	That the draft Northern Ireland Assembly (Elections) (Amendment) Order 2010, which was laid before this House on 25 October, be approved.

Hugo Swire: These orders update the law governing elections to the Northern Ireland Assembly and to district councils in Northern Ireland in advance of elections in 2011.
	I will deal first with the Assembly order, which is much the smaller of the two. That is because the law governing elections to the Northern Ireland Assembly was substantially amended as recently as 2009. Since then, some minor procedural updates have been applied to European and parliamentary elections that, for consistency, should also be applied to Assembly elections. For example, article 3 of the order makes provision to allow a candidate standing in the name of two or more parties to have one of those party's emblems on the ballot paper.
	It also enables a person who cannot sign his or her signature to use a mark in place of any signature required at the nomination stage. Article 4 requires individuals to give reasons if they request their absent vote to be sent to a different address from that at which they are registered. Those are clearly relatively small changes, but they nevertheless mirror updates made to the law since 2009 that apply at other elections in Northern Ireland, and they will provide for greater consistency.
	The draft Local Elections (Northern Ireland) Order 2010 is the more substantial order, and provides a much-needed update of the law governing local elections in Northern Ireland. The Electoral Administration Act 2006 made a considerable number of changes to the law governing parliamentary elections across the United Kingdom. As I have indicated, those changes were applied to Northern Ireland Assembly elections and European elections in 2009, but have not yet been applied to district council elections in Northern Ireland. They are set out in schedule 1 to the order, and they include allowing returning officers to correct procedural errors and supply documents in other languages and formats.
	Schedule 1 also makes provision for the control of donations to candidates in local elections in Northern Ireland, in line with the donation controls that apply at all other elections in Northern Ireland and across the UK. Schedule 2 makes changes to absent voting procedures, which again already apply at other elections in Northern Ireland. They include adding registered social workers to the list of those who may attest absent vote applications on the grounds of illness and disability, which will make it easier for people with disabilities who live in the community to apply for an absent vote. Schedule 3 aligns the law relating to access to and inspection of documents at local elections with procedures at all other elections in Northern Ireland.
	The order also amends the local election rules contained in schedule 5 to the Electoral Law Act (Northern Ireland) 1962. That includes updating the list of acceptable forms of photographic ID that can be presented in order to vote in Northern Ireland, which is of course crucial to ensure consistency of approach for all polls in 2011.
	The order is substantial, and I would not wish to detain the House by providing an in-depth description of each provision. I hope the House is satisfied that it contains small but important changes to the law that will provide much-needed modernisation of local election procedures in Northern Ireland and greater consistency with other elections across the UK.
	Finally, article 3 of the local elections order sets the date of the next district council elections in Northern Ireland as 5 May 2011. Hon. Members will be aware that in 2008, the previous Government agreed to a request from the Northern Ireland Executive to postpone the local elections that were scheduled to take place in May the following year. The House subsequently approved legislation to postpone the election until 2011, on a date to be specified nearer the time. The postponement was to allow time for new local government boundaries to be redrawn as part of the overall review of public administration that was taking place in Northern Ireland. That review was to provide, among other things, for the number of district councils in Northern Ireland to be reduced from 26 to 11.
	I regret to report that that reduction did not proceed as planned. Although the local government boundaries commissioner reported to the Executive with proposed new boundaries on time in 2009, an order has still not been brought before the Assembly to give effect to them. This June I made it absolutely clear to the Executive that there could be no prospect of further postponement of the elections beyond the two years previously agreed. I was also advised that further delay in passing the order to give effect to the boundaries would seriously jeopardise planning for elections in May 2011. The Executive therefore needed to take an urgent decision on whether the proposed new councils could be delivered in time to allow for elections to them in May 2011.
	On 15 June I received confirmation from the Minister of Environment in the Executive that the reorganisation would not now go ahead in 2011. I announced shortly afterwards that there was now no option but to hold elections to the existing 26 councils in May 2011. The local elections order will provide for that. I know that some hon. and right hon. Members may have concerns about those elections being combined with both Assembly elections and a potential referendum on the alternative vote. I have received the advice of both the Electoral Commission and the Chief Electoral Officer on this matter, and both are confident that a combined poll in May 2011 can be successfully delivered if the risks are properly managed.
	My officials are working closely with the commission and the Chief Electoral Officer in the run-up to the polls to ensure that there is an early identification and resolution of any potential problems.

Gregory Campbell: The Minister alludes to the difficulties that could be presented, with the distinct possibility-or probability-of our having three elections, using two different voting systems, on the same day. Will he ensure that as much co-ordination and co-operation takes place to ensure that after this legislation passes, which it undoubtedly will, the people of Northern Ireland get the maximum amount of information to ensure that they are fully prepared for what will be an unprecedented voting day next May?

Hugo Swire: The hon. Gentleman is absolutely right: we must do that. In fact there are two elections, which will be held in the normal way for the people in Northern Ireland, and the third is just a straight yes/no vote. I hope that the people of Northern Ireland will vote in the same way as I will.

Naomi Long: The Minister mentioned that in his meeting with the Electoral Commission, it had indicated that it was happy to facilitate all the elections taking place on the same day, provided that the risks were properly managed. Will he also agree that the commission said that it needed to ensure that it is properly resourced, given that there will be complications involving, for example, the number of ballot boxes available, and a number of other logistical issues, which will require more expenditure than a regular election?

Hugo Swire: The hon. Lady is absolutely right. Of course this needs to be properly resourced, and the necks of both the Secretary of State and myself are on the line if anything goes wrong. What we all want to avoid, on both sides of the House, are scenes such as those that we saw in the recent general election, when people were turned away from the polling stations. The matter is further complicated because some polling stations in Northern Ireland are quite small. There is also the issue of screening, and, as the hon. Lady said, of ballot boxes. I understand that the ballot boxes are being sourced at the moment. She is right to say that we must get it right, and to do that requires proper planning and funding.
	As I was saying, my officials are working closely with the commission and the Chief Electoral Officer in the run-up to the polls to ensure that there is early identification and resolution of any problems such as the ones that we have just heard about.
	I hope that the House is satisfied that the vast majority of provisions in these orders will make small but important changes to provide for greater consistency with elections elsewhere in the UK. I also hope that hon. and right hon. Members are reassured that the necessary steps will be taken to ensure successful combined polls in May 2011, and will therefore agree that the date of the next local elections should be set for 5 May next year. I commend these orders to the House.

Eric Joyce: Northern Ireland has made remarkable political progress, and that has been integral to the whole peace process. There are many people both inside and outside Northern Ireland who deserve great credit for that. Enormous efforts have been made, as is reflected in the celebrated success to date. For the first time in a generation, the overwhelming majority of people can live peaceful lives free from violence. Nevertheless, Northern Ireland still has a particular political ecology and the situation remains fragile. That is why any proposals to change the way in which the electoral situation works in Northern Ireland require great scrutiny, consultation and forethought. It is clear to us, however, that in the Government's rush to gerrymander Scottish, Welsh and Irish parliamentary seats, they are failing to listen to the deep concerns of Northern Ireland politicians about how ill-considered changes could have negative consequences for Northern Ireland.
	Clearly, the motivation and rationale behind the Parliamentary Voting System and Constituencies Bill, which will apply to Northern Ireland, are questionable. We support the principle of an AV referendum, yet the Government have refused to split it from the much more contentious matter of constituency design. The Government claim that over-representation is a primary driver of the changes, yet the UK sits in the middle of the EU table, with one MP per 110,000 people.
	The Government have also said that the reduced number of MPs will save money, but it is hard to see how that can be true. There is no evidence that reducing the number of MPs will cut case loads, so unless the Government intend to make MPs less accessible to their constituents, they will have to resource MPs for the relative uplift in constituency size. It is worth noting that this week, the Under-Secretary of State for Justice, the hon. Member for Huntingdon (Mr Djanogly) suggested that people who will no longer qualify for legal aid because of the changes that the Government are about to implement should go to their local Member of Parliament. It is therefore clear that the Government are intent on increasing MPs' case loads in any case. That will need to be resourced, so savings seem unlikely.

Anne McIntosh: I congratulate the hon. Gentleman on his position. Will he explain the relevance of his comments to the orders?

Eric Joyce: Yes, of course. The votes will take place on the same day, so the arguments that apply to the rest of the UK also apply to Northern Ireland. A particular complication is that, as a consequence of the orders, Northern Ireland will also have local government elections on the same day.
	Indeed, taken together with the Government's plan for fixed-term Parliaments, the Parliamentary Voting and Constituencies Bill appears to be designed simply to assure the coalition a five-year term, with constituency redesign giving it the best chance of re-election. We therefore believe that it sits outside the margins of acceptable democratic practice.
	The House of Lords has narrowly decided that the Parliamentary Voting System and Constituencies Bill is not hybrid, yet it is strange that the Government should decide that two Scottish constituencies will be treated as special cases and exempted, while Northern Ireland, where the Assembly may be directly affected by the measure, is not to be a special case. The strength of Northern Ireland's democratic institutions is crucial to the peace process, and the legislation governing the running of Northern Ireland Assembly elections was constructed specifically to ensure wide community representation. In his winding-up speech, will the Minister assure the House that the changes that he intends to make will not affect the delicate balance in the Northern Ireland electoral system, especially for smaller parties?
	Another primary concern is that the strict 5% thresholds, which are explicit in the Bill, will reduce the scope for the boundary commissioners to take local variables into account. Arithmetic will trump all other considerations and local communities will be split between constituencies. Professor Ron Johnson of Bristol university, for example, said that splitting some wards between constituencies will be inevitable. The Boundary Commission has confirmed that. Wards will no longer be the building blocks of constituencies. In many cases, natural geographical boundaries such as rivers will have to be ignored, as will community links and historical factors, which are so important in Northern Ireland.
	According to the Boundary Commission, the threshold is also likely to lead to frequent reviews, which means that some constituencies will change with each review. That will further destabilise the relationship between local communities-

Mr Deputy Speaker: Order. The orders do not relate to thresholds. Can we please focus on the orders?

Eric Joyce: Thank you, Mr Deputy Speaker.
	In the context of the reduced sensitivity to local variables, we believe that the constraints on local inquiries are especially serious. At a time of such significant changes, that is particularly important.
	The political ecology in Northern Ireland is particular; it is different from that in the rest of the United Kingdom. The Government plan to change the electoral system and the constituencies in Scotland, England and Wales, and they are not taking sufficient account of the peculiar variables that apply in Northern Ireland. As a consequence of the orders, local elections will take place on the same day as other elections, and there could be additional complexity. It is important for the Government to take into account the different nature of Northern Ireland. We do not believe that they are doing that. Consequently, the best interests of the people of Northern Ireland, and of the United Kingdom as a whole, will not be served.

Nigel Dodds: We do not often get three hours to debate Northern Ireland business. It is good that we will be here possibly till 10 o'clock.

Mr Deputy Speaker: Order. As the orders are being taken together, we have just an hour and a half.

Nigel Dodds: May I express my great frustration and annoyance at our being denied time to debate these important matters? However, I am sure that your statement will come as a great relief to other hon. Members, Mr Deputy Speaker.
	In all seriousness, as the Minister said, the orders are technical, although they flow from significant primary legislation, which we have already debated at some length since we returned from the summer recess.
	On the issue of having the three elections on one day, the orders are designed to make the elections run smoothly and prevent difficulties in the conduct of the elections for the chief electoral officer, his officers and, not least, the electorate. That is welcome, particularly on issues such as making sure that the timetable is consistent for both the council elections and the Assembly elections. There has been some criticism in previous years in Northern Ireland about the rather strange timetable adopted for council elections compared with Assembly and parliamentary elections. If my memory serves me right, when I served in local government and had to submit nomination papers, that had to be done four and a half weeks before election day, so there seemed to be an inordinately long campaign for local government elections compared with others.
	Obviously it is important that the timetable is synchronised and that issues such as postal and proxy votes are properly managed so that people applying for them receive one package through the post containing the necessary forms and one containing the three ballot papers. I am glad to hear that there will be three separate, differently coloured ballot papers. I am sure that we have all learned the lesson from Scotland-this never happened in Northern Ireland-when there was an attempt to have two different kinds of ballot on one paper. That was a big mistake and I am sure that it will never happen again.
	We are where we are as far as the coincidence of the council and Assembly elections and the referendum is concerned. Obviously, it is preferable that, where possible, there are not so many choices on so many matters before the electorate on any given date, but people in Northern Ireland are used to having joint elections. Indeed, the council elections in 2001 and 2005 coincided with a Westminster general election. If memory serves me right, it may have happened before that. I know that at one time elections were deliberately brought together by the then leader of the Ulster Unionist party, which is no longer represented in this House, because he thought that it would increase turnout and support for his party. As with so many of his calculations, it did not quite work out that way on the day.
	This is a sensible set of provisions for 5 May next year. The Minister referred to the date of the council elections for next year, and said that it was the result of the Executive not acting on the recommendation to proceed with the reform of local government. He did not go into the reasons for that, of course, but I would not want the House to be under the impression that this was the result of a lack of desire among most of the parties in the Assembly to make progress on the issue. Even if the reform did not lead to a reduction in the number of councils, other reforms were proposed, such as greater collaboration among councils and the various departments for which they are responsible. Unfortunately, it was not possible to achieve the major cost saving that would have accrued to councils in Northern Ireland because of the intransigence of one party, Sinn Fein, which rejected that constructive proposal. Therefore we are left having to proceed with the election with no real reform to local government due.
	When costings were carried out for the council reforms, it became clear that there would have been considerable up-front costs. Given that the Northern Ireland block grant has been severely hit as a result of the recent comprehensive spending review, and the already severe restrictions, difficulties and challenges facing the Northern Ireland Executive on public expenditure, it was felt that this was not an appropriate time to proceed with that particular reform. Obviously, when it comes to choosing between council reform and health expenditure, education and so on, people are right to choose the latter. That is the background to the reason for the proposals for the date of the election and why they will involve the same number of councils as previously.

Jeffrey M Donaldson: The hon. Member for Falkirk (Eric Joyce), who spoke for the Opposition, referred to the reduction in the number of constituencies in Northern Ireland that may result from legislation going through Parliament at the moment and wondered what would have happened had there been a reduction in the number of councils. Is there not a danger in Northern Ireland that the larger we create constituencies and councils, the more removed government becomes from the people?

Nigel Dodds: My right hon. Friend is absolutely right to draw attention to that. The previous Government proposed reducing the number of councils to seven. I am the first to support a reduction in governance and the number of elected officials and all the rest of it, but a reduction to seven councils would have meant that Northern Ireland councils would be bigger than any other region of Europe. I am sure that the former Minister, the right hon. Member for Wythenshawe and Sale East (Paul Goggins), will go into considerable detail on that in his speech.
	The lack or inadequacy of consultation on the primary legislation with parties in the Assembly and the Executive has been mentioned. I do not want to go over that, but consultation on Assembly and local elections with the chief electoral officer of Northern Ireland is mentioned in the orders and the explanatory memorandum. I recently met the new chief electoral officer. He is a very impressive officer and I think he will do an excellent job, but it is clear that he sought, during consultations on both the primary legislation and the secondary legislation that we are debating, some changes to the way in which elections are carried out that were not proposed by the Northern Ireland Office.
	I am thinking in particular about the removal of polling agents from Northern Ireland polling stations. The Minister is nodding his head, so perhaps he has held discussions on polling agents. This is an important matter. Commendably, we have a sophisticated and elaborate system to tackle identity fraud and the abuse of the electoral system. As has been said, people must now produce certain types of photographic identification or sign postal votes, and their signatures are carefully examined. Postal and proxy vote abuse has been considerably reduced from the large-scale abuse that took place in previous elections. Our system is a model for dealing with postal votes for the rest of the UK. If the rest of the UK wants to cut out the abuse of postal voting, people should look at the administration and regime in Northern Ireland. Clearly, our system is now without any kind of abuse at all.
	However, why do we still need polling agents-representatives of political parties-sitting in polling stations in Northern Ireland? The NIO, which is still responsible for elections, should address that, because it is clear that one or two parties-I am thinking of one in particular-clearly abuse that for purposes not in keeping with the legislation. Information is taken out of polling stations, so that voters who have not voted can be identified and then, of course, visited. They will be asked, "Why have you not voted?" and told to get out to vote. In certain parts of the Province and in certain circumstances, people will feel intimidated by that, so polling agents are being used for nefarious purposes. I urge the NIO to take that seriously when it next gets a legislative opportunity.

Naomi Long: Does the right hon. Gentleman agree that one difficulty is that when people are approached in those circumstances and they realise that the information has been garnered at the polling station, they fear that the fact of how they have voted is also available? People are often quite intimated by the notion that the ballot is less than fully secret.

Nigel Dodds: The hon. Lady is absolutely right. We might sit in the comfort of this Chamber and know that the ballot is secret and that the information cannot get out, but for a lot of people, exactly the scenario that she has painted is what they believe to be the case. They believe that because information has been gathered on whether they have voted thus far, people will be able to find out how they have voted, and the people who call at their doors make no effort to disabuse them of that notion either. This is an important matter. Nowadays there is no reason at all for that provision to remain, if we really are going to ensure that we have fair and clean elections in Northern Ireland. As has been mentioned on a number of occasions, the ecology of the electoral system is different-and it is different: people are more easily intimidated by the way certain parties operate-so removing that provision would be a step towards improving the democratic process and making people less concerned about exercising their franchise.
	The management of elections by the chief electoral officer and the issue of resources, which is an important point, have already been mentioned. In my discussions with the chief electoral officer, the point that he laid most emphasis on was resources. The matter of ballot boxes has also been raised, which is another issue that I know has been discussed. All sorts of imaginative suggestions have been canvassed, and I hope that it will be possible to find a sensible solution that minimises costs.
	There is also the issue of polling stations. The Minister referred to the fact that polling stations in Northern Ireland were sometimes smaller than they are elsewhere. Again, I would urge him in his discussions with the Electoral Office for Northern Ireland to do what I have done, which is to urge the authorities to be a bit more imaginative when it comes to the buildings and premises that they use as polling stations. People are too fixated on the traditional buildings-"We've always used this building and we can't depart from tradition"-whereas new premises have sprung up, and many people are used to doing things differently. Sometimes the electoral officers are far too hidebound by the past in managing this issue, so I would again urge the Minister in his discussions respectfully to ask the chief electoral officer to be much more flexible. There is a consultation under way-certainly in my constituency, and I am sure in those of other hon. Members-that is closing in December on the very issue of polling stations, so this is an opportune moment for the matter to be pursued.
	Finally, so as to leave plenty of time for others who wish to contribute to this debate, let me say something about enforcement. The local elections order is fairly substantial, as the Minister said, as is the Assembly order. When I read through the detail of all the rules, what struck me was this: what happens when those rules, particularly those applying to the conduct of the election by candidates and parties, are breached? In my experience, it seems that we can prescribe all sorts of rules, from rules on the colour of ballot papers to rules on whether the X or the "1" should be marked in black pen or in pencil-we debated that in the primary legislation-or what would constitute a clear preference, all of which are matters of great detail. Indeed, the forms are set out in incredible detail in the legislation, so the issue is extremely important. Yet I have found that when matters are drawn to the attention of the authorities-the chief electoral officer and then the people responsible for prosecuting such matters-very little is ever done about breaches of the rules.
	I want to refer to a matter that I raised during the debate on the primary legislation on the parliamentary voting system. One party in Northern Ireland-Sinn Fein-seems to be adept at producing detailed replicas of polling cards and other official material. On one side they appear to be authentic, but the other side has party political propaganda, some of it of a vicious nature, designed to persuade people that not only is Sinn Fein recommending voting a certain way, but that the electoral authorities are also doing so.
	There were examples of that practice during the last Westminster election. One was in the constituency of the hon. Member for Foyle (Mark Durkan), and there was at least one in my constituency. There were also other illegal practices. The matter was drawn to the attention of the then chief electoral officer, who took the matter seriously, and it has been referred on to the authorities to consider what action should be taken. We know that there are serious consequences, and we will watch carefully, as will the electorate and the people of Northern Ireland, as well as the media, to see what happens about a clear and flagrant breach of electoral law.
	I do not expect the Minister to respond in any shape or form on the specifics of a case, but I raise the matter because it concerns me that from time to time in Northern Ireland elections, whether local, Assembly or Westminster elections, all sorts of illegal practices go on. Vast amounts of money are spent, but the election returns show that only a small amount was spent when everyone knows that tens of thousands of pounds have been spent but never declared. Such matters should be taken seriously.
	It is all very well to pass legislation, regulations and rules. We debate them at length, and scrutinise them properly, but we must ensure that there is effective and proper enforcement, otherwise people will take the signal that at the next election they can push the boundaries even further and get away with far worse. That is insidious, and it needs to be stamped on. I am happy to lend my support and that of my right hon. and hon. Friends to the orders.

Paul Goggins: It is always a pleasure to follow the right hon. Member for Belfast North (Mr Dodds), but I hope that I do not disappoint him with the length of my speech, which will be very short. As the Minister who, in January last year, took through the order to postpone the elections in 2009, I thought I owed the House at least one or two brief comments.
	First, I thank the Minister for keeping the promise that I made in Committee in last January that the Northern Ireland council elections would be held in 2011. Members of the Committee questioned what guarantees there would be that council elections would be held that year, and I asked them to back my judgment, which they did. I am not in a position to deliver on that judgment now, but the Minister is, and I thank him for following through my commitment.
	The Minister explained that the reason for the delay was connected with the review of public administration, an initiative that began with the Executive in 2002. Direct rule Ministers took it over, but it then quite rightly returned to the Executive as their responsibility in 2007. Indeed, I remember that in 2007 Ministers in the Executive took up the issue with some relish because they could see the merits of greater efficiency by reorganising public bodies, whether health, police or local government.
	In April 2008, the then Minister of the Environment, Arlene Foster, wrote to the then Secretary of State, my right hon. Friend the Member for St Helens South and Whiston (Mr Woodward), with a request that the council elections be delayed for two years to 2011. She made the compelling case on behalf of the Executive that the complexity of reorganising the local council structure and boundaries was quite a challenge: the single transferable vote system would require new council wards, new districts and new grouping of district electoral areas. Although we were reluctant to take the dramatic step of cancelling elections, we felt that, in view of the exceptional circumstances, it was justifiable and introduced the necessary legislation.
	I had further extensive discussions with Arlene Foster's successor, the hon. Member for East Antrim (Sammy Wilson), and his successor in the role, Edwin Poots. It is of course a matter of regret that Edwin Poots wrote to the Minister in June this year to say that, for various reasons, it would be impossible to proceed with the changes to the local council boundaries. Great frustration was expressed about that, not least, I am sure, by the Minister himself because he will be able to see the advantages involved. None the less, these challenges must now be tackled by the Executive Members and by the Minister for the Environment in Northern Ireland, rather than by this House. Indeed, if I were to stray and to offer any more opinions to the right hon. Member for Belfast North and his colleagues, they would soon intervene on me.
	Some concerns remain, however, and I should be interested to hear the Minister's comments. Having now set the date for the council elections in 2011, the pressure for local government reform is off, in a sense, which is a pity because I am sure that the Minister in the Executive will want to see the reforms put in place, as will other Members of the Executive. There would be great dividends if that were possible. Will the Minister tell us tonight whether there are any signs of progress? If reform were to pick up apace, would he be prepared to come back to this House with a proposition to bring forward the date of the next local council elections in Northern Ireland, which would otherwise happen in 2015?

Nigel Dodds: The right hon. Gentleman was much respected for the work he did as a Minister for Northern Ireland, but any notion of bringing forward the date of the next council elections from 2015 would not find favour with the parties in Northern Ireland, not least because it would be deeply unfair on those who had been elected on the basis of a four-year term suddenly to say to them, "Your term is going to be truncated." So although I understand where he is coming from, and the sentiments that he has expressed, I urge him to rethink that proposition.

Paul Goggins: The right hon. Gentleman makes a fair point, but I am sure that he will share my concern, given his deep knowledge of the electoral system in Northern Ireland, that the council boundaries are way out of date. There is therefore some urgency in trying to move to new council boundaries that reflect a more modern approach. I do not expect a positive answer from the Minister about bringing forward the date of the next local council elections after 2011, but I urge all right hon. and hon. Members to see this as an urgent matter and not one that can simply be left on the shelf. I am concerned that, with the introduction of the Parliamentary Voting System and Constituencies Bill, attention will now be focused more on constituencies and away from local government structure in Northern Ireland, and anything that will maintain the sense of urgency about the need for the local government reform will be a good thing. I repeat, however, that these are no longer matters for this House; they have now quite rightly been devolved to the Executive in Northern Ireland.
	There is also the question of the practical implications of holding the various elections on the same day. I know that the Minister said he had consulted on this, and that he was confident they could all be held on the same day. I pay tribute to all those who administer the elections in Northern Ireland professionally and effectively, and I do not call into question their ability to conduct those elections one bit, but there is a debate about the various issues that are at stake: elections to the Assembly, elections to local councils and, probably, the question of whether to have an alternative vote system or not. That has been debated endlessly elsewhere. We are talking about elections using the single transferable vote system for councils and for the Assembly, which is very complicated and takes time. I urge the Minister to keep up the pressure on those who will administer the system to make sure that all the right questions are asked and answered.
	There is the further point-I am sure that Minister will have considered it-that if the Fixed-term Parliaments Bill is passed as drafted, in 2015 we will have council elections, a general election and Assembly elections on the same day, using different-possible very different-electoral systems and under new boundaries. This will be the height of complication. Again, I urge the Minister to pay close attention. He said in the course of his remarks that his neck is on the line. I well know that feeling, but I am sure he will do a fine job.

Martin Horwood: Surely the height of complication would be the situation in American states such as Montana, where people voted for the American President, for the Congress, for the state governor, in state elections and sometimes even in local elections-sometimes with additional propositions as well. They seem to manage it in Montana, so surely they could manage it in Northern Ireland.

Paul Goggins: I am not saying that those who administer elections in Northern Ireland would be incapable of doing so. I am simply making the point that this will place a burden on the system in Northern Ireland that it has never faced before. There are also implications for the electoral cycle. In perpetuity-unless the Minister offers alternatives-council elections and Assembly elections will always be held on the same day in Northern Ireland on a four-year cycle. Again, I think that should be a cause for reflection. However, I have nothing but good wishes for the Minister in ensuring that all these issues are dealt with. I am sure he will do very well. In so far as he ensures that these elections are held properly in 2011 and subsequently, he will have my full support.

Naomi Long: I support the orders. I would like briefly to raise a number of issues, some of which have already been touched on by other Members.
	First, I express my disappointment that greater progress has not been made with the review of public administration in Northern Ireland, particularly as the local government elections were postponed to facilitate that process. It has become something of a political soap opera-not quite as long running as "Coronation Street" and certainly not as entertaining. It has not reached a satisfactory conclusion as yet, and there seems to be little prospect that it will-despite the fact that it has cost a lot of money. Most people would have liked to have seen this issue brought to a more satisfactory conclusion.
	Given that the last local government elections were held almost six years ago there is a democratic deficit, so it is important to give people the opportunity to refresh their mandate in local government. It is disappointing that this is being done in the absence of reform.
	I noted what the right hon. Member for Wythenshawe and Sale East (Paul Goggins) said about the possibility of bringing the elections forward, but I concur with the right hon. Member for Belfast North (Mr Dodds) as I do not believe that further tampering with the electoral cycle is the best way of dealing with the issue. I agree that there is an urgency about taking the review of public administration forward in Northern Ireland. However, local government has demonstrated in the past its ability to co-operate even under its current structures-through arc21, for example, which deals with a number of councils' waste. At the very least, we should expect enhanced co-operation so that some savings can be made without having to tamper with the cycle further.
	I seek the Minister's reassurance about photographic identification. In May, Westminster elections and council by-elections were held on the same day in my constituency. People turned up to vote, only to find that their photographic ID was admissible for one election but not for the other. This caused extreme distress, particularly for older people, who were relying on transport passes to get the correct photographic ID. They were not able to vote in both elections, as they had expected. I hope that the arrangements involving identification documents can be simplified so that when people turn up at polling stations, they are fully confident that they will be able to cast their votes.
	I hope that the Minister will reflect on another issue, although I do not expect a full answer from him this evening. Given that the qualification to vote is established when the electoral register is compiled, which means that people who are on the register and duly marked down for an election have the right to vote in it, the purpose of ID is simply to establish exactly who they are. However, there remains a restriction for foreign nationals who have a right to vote in elections, but no right to use their passports from their home nations as a means of identification. They experience significant difficulties when they try to vote in elections in which they are entitled to vote, but cannot obtain valid identification documents. Given that the purpose of the documents is simply to prove that individuals are the individuals listed in the register, I think that the matter should be dealt with to ensure full participation in the community by those who wish to vote.
	Along with other Members, I have already raised concerns about the holding of three elections on the same day next May. The Minister made quite a brave statement when he said that his neck would be on the line if the logistical issues were not handled well. It remains to be seen whether people will want to hold him to that commitment, but I have to say that this is not just about the logistical issues, although they are hugely important. Of course we want the Electoral Commission to be properly resourced to ensure that the elections can be discharged fairly, but we should also consider the democratic deficit that may result from the holding of elections at the same time.
	There is always a risk that the Assembly elections and the issues connected with them-I think that it usually happens this way round-will obscure important debates about local governance in relation to local government elections. We need to consider how much media coverage is given to the local government debate, which has a direct impact on people's lives but tends to be less glamorous-for want of a better word-than the issues dealt with in the Assembly. However, there is a chance that both issues could be overshadowed by the national campaign on the referendum. In Northern Ireland particularly, for obvious reasons, people might focus on the Assembly election, given its importance, rather than on the impact of electoral reform and local government.
	A number of Members have said that we could surely cope with these complex elections, and it is true that ours is a very sophisticated electorate. There was a period during which we had an election, if not two, almost every year. People have become accustomed to voting and to how to cast their votes. The electorate are sophisticated in terms of being able to manage the electoral process, and, as others have pointed out, we have had two elections on the same day before. Nevertheless, the additional complication caused by a third election on a very different issue causes me some concern.
	I believe that the combination of the local government and Assembly elections, while not ideal, may be manageable. I seek the Minister's reassurance that he will do all in his power to ensure that people are fully informed about the issues on which they are voting and the consequences of their votes, particularly with respect to the referendum and the two elections that will take place on the same day, and to ensure that the Electoral Commission is properly funded in order to be able to notify people.

Nigel Dodds: The Electoral Office for Northern Ireland, or perhaps the Electoral Commission, has a responsibility to urge people to vote much earlier in the day. We have already experienced problems with queuing, and given that there will be separate ballot boxes, the process will take much longer on this occasion. It is therefore vital for a press and media campaign to be organised officially at an early stage. People must be told, "Do not do what you normally do and wait until the last minute, or after teatime; get out and vote earlier." That would be a very profitable campaign on the part of the commission.

Naomi Long: I entirely agree. I think it hugely important for people to be encouraged to cast their votes at the earliest opportunity. When people have turned up with the wrong documentation, it has been useful for them to be able to revisit the polling station if necessary. However, it would be beneficial generally if we could prevent what tends to be a post-teatime rush, with queues forming late in the day. I hope that that can be impressed on the Electoral Commission, and that the commission can be properly resourced so that its campaign is foremost in people's minds. People have become accustomed to voting at times of the day that are convenient for them. On this occasion, there will be three different elections with three different ballot papers, and it is important that people recognise how much time will be consumed in filling them in.
	I seek the Minister's reassurance particularly in respect of photo-ID and ensuring that people are properly informed about the nature of the elections taking place on the day.

Jeffrey M Donaldson: I will be brief, as there are just a couple of issues that I want to raise with the Minister.
	Wards are the building blocks for both local government districts and parliamentary constituencies, and one of the consequences of the delay in the local government elections is that the ward boundaries have not been reviewed for a considerable time. In my constituency, as a result of the most recent parliamentary boundary review, the ward of Derriaghy is now split between the Lagan Valley constituency and the Belfast West constituency. It is the only ward in Northern Ireland that is split. Other wards need to be reviewed, as there have been significant population movements since the last ward boundaries revision.
	As a result of legislation currently passing through the House, we now face the prospect of new parliamentary boundaries being created and a reduction in the number of constituencies, possibly from 18 to 15 in Northern Ireland. That review will take place on the existing ward structures. I therefore seek an assurance from the Minister that we will have a review of the ward boundaries at a very early date. That has been held back because of the review of local government, but the boundaries are now significantly out of date and there are disparities in ward sizes-and, as I have mentioned, in at least one case a ward is split between two parliamentary constituencies. We would be interested to hear what proposals the Minister has in respect of the urgent need to review ward boundaries in Northern Ireland.
	My second question relates to the counts that will follow the two elections and the referendum in Northern Ireland next year. What will be the order of precedence for those counts? Will the referendum be counted first, because it is a UK-wide referendum? Will the Assembly election count take place before the local government election count, as has been the case in the past? Will the Minister give us some idea as to what will be the order of the counting of votes following these three separate ballots, and will they all take place in the one counting centre in each of the local areas, or will the referendum ballot be counted separately? I seek clarity on these matters.

Hugo Swire: This has been an interesting debate and a number of interesting points have been raised. The shadow spokesman, the hon. Member for Falkirk (Eric Joyce), touched only lightly on the proposed legislation under discussion, and seemed to refer rather more to the Parliamentary Voting System and Constituencies Bill. He talked about various topics including the House of Lords, Scotland, the boundary commissions and a number of MPs, none of which related to what we are discussing tonight, but his comments were nevertheless interesting for my ministerial colleagues who are present in the Chamber, as they have been discussing that Bill for many days.
	The hon. Gentleman said that the changes to the Northern Ireland electoral system are confusing. The changes we propose ensure consistency across all elections in Northern Ireland, making the electoral system clearer for candidates, administrators and voters, and the changes are minor and principally administrative.
	The right hon. Member for Belfast North (Mr Dodds) asked a number of interesting questions. He talked about electoral law offences. It is worth putting on record that if a person is suspected of committing such an offence, the chief electoral officer should refer the matter to the police and the prosecuting authorities. Prosecutions are a matter for the Public Prosecution Service, of course. He also talked about the timetabling of local elections. Local election procedures regarding the timetable will now be aligned with the Northern Ireland Assembly timetable by virtue of this order.
	The right hon. Gentleman also talked about a subject that I discussed: polling agents. As the former Northern Ireland Minister, the right hon. Member for Wythenshawe and Sale East (Paul Goggins), will no doubt remember, the previous Government undertook a full public consultation on that in 2008. There was no consensus then on whether they should be abolished. It is also worth noting that the law allowing for polling agents applies across the UK, but we will review this again after the May 2011 elections. I must confess that I have a considerable interest in this point and am more than happy to discuss it with the right hon. Member for Belfast North over the coming months.

Nigel Dodds: I look forward to those discussions. The Minister mentioned a lack of consensus. Obviously we will not get consensus across all the political parties, for the very reasons that I outlined. Would he not put a lot of weight on the views of the chief electoral officer, who surely has an independent view on all this in terms of the conduct of elections?

Hugo Swire: I do not think that I am breaking any confidences by saying that I have discussed this matter with the chief electoral officer and his predecessor. I can only say that I am more than happy to discuss it with the right hon. Gentleman. I have considerable interest in this and considerable sympathy with where he is coming from. He also raised the issue of political donations. As he will know, the consultation on the provision for donations to political parties in Northern Ireland to be made confidentially concluded on 25 October, and we are considering how best to take that forward.
	The right hon. Member for Wythenshawe and Sale East spoke, as usual, intelligently and with tremendous knowledge. I know that he shares my frustration that things have not moved along as much as we would have liked on local government reorganisation. He asked whether there are signs of progress, and one hears from time to time various rumblings coming from the hill. The answer is that we must not relax on this matter and we must keep up the pressure, and he was right about that. I shall return to that in a moment, if I may. He also spoke about the combined elections in 2015 and he will not be surprised to hear that no decision has yet been taken-we are trying to get through next year first. I would prefer to await the outcome of the combined polls in 2011 before taking a decision on whether it is desirable to combine elections in 2015 or whether a provision should be made for their separation.
	I was asked what the Government are planning to do about the coincidence of elections in 2015. I am writing to all Northern Ireland parties setting out our proposed approach and requesting their views. It should be remembered-we have been discussing this recently in terms of other legislation-that the Secretary of State already has a power to alter the Assembly election date by two months. We will see whether we need to do that at that time.
	The right hon. Member for Lagan Valley (Mr Donaldson) talked about outdated boundaries. We would very much hope that the Executive have agreed new boundaries to ensure that they are updated well in advance of 2015, but in any case, I am proposing to write to the Minister of Environment to take forward such a review immediately after the 2011 elections. I believe I am right in saying that the current boundaries are 19 years old, which is not at all acceptable, so clearly this is something that they need to get on with, regardless of local government reorganisation.
	The right hon. Member for Wythenshawe and Sale East asked whether we would bring forward elections. We have received no such request and we would need to consider such a proposal carefully, as we would want to ensure that the transition to new councils and the new set-up was in its final stages. We do not want to chop and change dates without good reason. He would probably support that approach, given that he said that it was with extreme reluctance that he postponed the date of the original election; I believe he said that he did not do that lightly. Nor should we tamper with this. We will have elections in May, but we need to keep up the pressure.
	The hon. Member for Belfast East (Naomi Long) raised some interesting points about ID, which I had raised with officials today. It is true to say that this order ensures that requirements at all elections are now consistent in Northern Ireland. I am told that people will be able to use the Translink smartpass, provisional driving licence and other smartcards. She also asked about foreigners and foreign ID. It is true that someone can now use an EU driving licence or an EU passport to vote in Assembly and local elections.

Naomi Long: One example that we had a problem with was non-EU documentation, such as that from Commonwealth countries. For example, people who are resident ordinarily in Northern Ireland and have Canadian or Indian passports cannot use them as a document to vote, even though they are entitled to vote in that election.

Hugo Swire: The hon. Lady raises a good point. We should make it perfectly clear well in advance of the elections what photo ID will be acceptable. There could be nothing more frustrating than queuing to take part in three elections, arriving almost as the clock is striking 10 o'clock, only to be told that one has the wrong form of ID. That is something we should consider and, again, we need to be properly prepared. We would not want people in any great numbers-or, indeed, any individual-to feel that they had been disfranchised because they were not aware that their ID, which they thought was quite proper and which could be used on airlines and so on, was not appropriate for an election. We heard loud and clear what the hon. Lady had to say.
	The hon. Lady also asked about the Assembly election dominating debate, leading to local issues being ignored. It is worth pointing out that, as the right hon. Member for Belfast North mentioned, local elections were held successfully alongside Westminster elections in Northern Ireland in both 2001 and 2005. The hon. Lady said that Northern Ireland has a sophisticated voting population, and it is up to the individual candidates to set fire in the minds and hearts of their potential electorate- [ Interruption. ] Not literally, but in terms of trying to get interest in the election. I think the hon. Lady is probably wrong on this point because having three elections, albeit two voting one way and another being a straight yes or no, will mean that people will talk about the elections much more. I would not be at all surprised if we had a very good turnout. I do not think that one issue should eclipse the other-I think that we are going to have a very political new year.
	The right hon. Member for Lagan Valley mentioned ward boundaries. Again, that is a matter for his colleague the Environment Minister in the Executive, but, as we have said, we cannot go on working on boundaries that are nearly 19 years out of date. He also asked a specific question about the electoral night, and I am looking forward to the morning after, which I hope will be one without too much trouble. I am told by the Parliamentary Secretary, Cabinet Office, my hon. Friend the Member for Forest of Dean (Mr Harper), that the Electoral Commission's recommendation is that the Assembly election should be first, the referendum second and the local government election third, on the Monday. I believe that that has already been published.
	It has been an interesting debate, but not a controversial one. The legislation is necessary to tidy up some anomalies. The contributions made by right hon. and hon. Members of all parties will be listened to by the Electoral Commission and the chief electoral officer. Let us hope that we have a good day next year.
	 Question put.
	 The Deputy Speaker's opinion as to the decision of the Question being challenged, the Division was deferred until Wednesday  24 November (Standing Order No. 41A).

Northern Ireland

Motion made, and Question put,
	That the draft Northern Ireland Assembly (Elections) (Amendment) Order 2010, which was laid before this House on 25 October, be approved. -(Mr  Swire .)
	 The Deputy Speaker's opinion as to the decision of the Question being challenged, the Division was deferred until Wednesday  24 November (Standing Order No. 41A).

Business without debate

DELEGATED LEGISLATION

Motion made, and Question put forthwith (Standing Order No. 118( 6 )).

Disabled Persons

That the draft Disabled People's Right to Control (Pilot Scheme) (England) Regulations 2010, which were laid before this House on 12 October, be approved.- (James Duddridge.)
	 Question agreed to.
	 Motion made, and Question put forthwith (Standing Order No. 118( 6 )).

Health and Safety

That the draft Justification Decision (Generation of Electricity by the EPR Nuclear Reactor) Regulations 2010, which were laid before this House on 18 October, be approved.- (James  Duddridge .)
	 The Deputy Speaker's opinion as to the decision of the Question being challenged, the Division was deferred until Wednesday 24 November (Standing Order No. 41A).
	 Motion made, and Question put forthwith (Standing Order No. 118( 6 )).
	That the draft Justification Decision (Generation of Electricity by the AP1000 Nuclear Reactor) Regulations 2010, which were laid before this House on 18 October, be approved.- (James  Duddridge .)
	 The Deputy Speaker's opinion as to the decision of the Question being challenged, the Division was deferred until Wednesday 24 November (Standing Order No. 41A).
	 Motion made, and Question put forthwith (Standing Order No. 118(6)).

Regulatory Reform

That the draft Legislative and Regulatory Reform (Regulatory Functions) (Amendment) Order 2010, which was laid before this House on 21 October, be approved.- (James  Duddridge .)
	 Question agreed to.

EUROPEAN UNION DOCUMENTS

Motion made, and Question put forthwith Standing Order No. 119(11)),

EU Rule of Law Mission in Kosovo

That this House takes note of the unnumbered Explanatory Memoranda, dated 2 June 2010 and 29 September 2010, from the Foreign and Commonwealth Office on two Council Decisions amending and extending Joint Action 2008/124/CFSP on the European Union Rule of Law Mission in Kosovo (EULEX); and agrees with the Government that the mission is making an important contribution to improving the rule of law in Kosovo.- (James  Duddridge .)
	 Question agreed to.

WARD CLOSURES

Motion made, and Question proposed, That this House do now adjourn. -(James Duddridge.)

Anne McIntosh: I am delighted to have secured the opportunity to debate these issues. The national health service is a national treasure. During any one year, all of us will have cause to visit a GP or hospital or to see a nurse, or we have a family member or friend who will do so. Members of my family have devoted years of service to the health service as GPs, a surgeon or nurses. I record my utmost admiration for all those working in the national health service.
	The purpose of this debate is to consider the decision-making process in ward closures and other major service changes. I particularly invite the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), to address in her response the lack of consultation over the closure of Ryedale ward at Malton hospital. I regret both the closure and the lack of consultation.
	I shall analyse the reasons for closing Ryedale ward at the end of the so-called pilot project and look at the consultation procedure at that stage. I shall highlight the need for services and care provision in a sparsely populated, deeply rural area, with an increasingly ageing population.
	People care passionately about their local hospital and greatly value their general practitioner. Thirsk and Malton are well served by three community hospitals-Lambert hospital in Thirsk, St Monica's in Easingwold and Malton community hospital. In addition, there are acute hospitals at Scarborough and York and Friarage hospital at Northallerton. What increasingly alarms me is the trend over recent months to remove much-needed services from community hospitals, such as the minor injuries units at Lambert hospital and Friary hospital, in the constituency of my right hon. Friend the Foreign Secretary. Diagnostic services are being removed from Malton hospital, diabetes test strip services are being stopped and there is a rumour that the operating theatre at Malton is due to close within two weeks. Furthermore, there is a threat to decommission all enhanced services in the last quarter of the year-again without consultation.
	The local area medical committee has written to the Secretary of State for Health to raise those issues, and particularly to draw my right hon. Friend's attention to the threat to decommission enhanced services locally, including chlamydia screening, smoking cessation, complex drug monitoring and other services. The primary care trust held no consultation about the cuts with local practitioners. The committee believes that the cuts are damaging patient care and that they will undermine the strategic aim to provide services at lower unit cost, nearer to patients in the community. The hard work and good will of GPs are being pushed to the limit by the expectation that GPs will absorb more and more cuts and accept an increased work load. There is a threat that the blinkered goal of financial balance and short-termism, following seven years of unchecked cuts, will cause irreparable damage to primary care and leave GP practices damaged and disengaged.
	There is a definite pattern in the way that services at community hospitals are being cut without consultation. The Ryedale ward, which was one of two wards at Malton hospital, the other being the Fitzwilliam ward, had 21 beds. It was recently refurbished at a cost of £1.25 million, a quarter of which was raised locally. It opened in May this year. I had cause to visit the refurbished service during my extended election campaign. Patients in Ryedale ward received intensive rehabilitation after a fall or an operation, allowing them to return safely to their home environment.
	The ward closure has been termed a pilot scheme, but I am mindful that once a ward has been closed, it is difficult to re-open it. Importantly, the primary care trust in this instance is both the commissioner and the provider of services at Malton hospital. This is most unusual. It is now frowned on as unacceptable and, I understand, is being stopped through the Transforming Community Services agenda.
	The way in which the ward was closed is a textbook example of how not to proceed. First, the primary care trust claimed that there was no question of Ryedale ward at Malton hospital closing. Then, after a decision taken on 23 September, the beds were removed from the ward by stealth until there were none remaining and the ward was effectively closed on 19 October. Even at a private meeting with the Health Minister and me on 12 October at the Department of Health, the PCT could still not admit that the ward was closing. Before the closure there had been almost no consultation of the relevant GP practices across the Ryedale area, or of nurses or patients.
	Yesterday I lodged a petition with the signatures of more than 1,800 residents of the Ryedale area, strongly objecting to the way that the bed closures had happened without public consultation. I have had a large mailbag from constituents and heard many testimonies of the excellent care that patients received, to their satisfaction and to that of their loved ones, in the Ryedale ward at Malton hospital. The correspondence has been universally against the closure of the ward.
	Many local health practitioners are wary of the so-called hospital at home scheme replacing care on a ward. There is deep concern that no advance warning or training was given before the hospital at home scheme was announced as part of the ward closure. Some patients require hospital treatment, although others might prefer to be treated at home. The scheme may lead to patients being admitted as an emergency to an acute ward, which is distressing and more costly than care on a community ward and deeply worrying to patients and their loved ones.
	The Ryedale ward should not have closed without the agreement of the health practitioners and the local community. The Secretary of State has received the conclusions of a study of clinical activity on the Ryedale ward to assess whether identified clinical need could be managed effectively at home by the enhanced community support scheme. Those conclusions, which I should like to share with the Minister, are that, on balance, Ryedale should probably have been kept as a 10 to 16-unit, if not a 21-unit, ward for these purposes. There is general concern that the closure of Ryedale ward flouted the conclusions of that study, which I commend to the Secretary of State and to my hon. Friend the Minister.
	What could the reasons for closure be? Given the predicted deficit in the primary care trust, my fear is that there is a financial motivation behind the recent trend of events and the subsequent lack of consultation. The budgets are being cut so radically that there might be insufficient funds to run all the services by the time that GP commissioning commences in 2012. I accept that there is a funding issue. The current funding allocation to North Yorkshire and York is the 13th lowest of the 152 PCT areas, and 12% below the strategic health authority average. There might be insufficient funds to run all the services at such time as the GP commissioning service commences.
	If the trend of service cuts continues, our community hospitals could be reduced to a size where it is no longer viable to keep them open. In a rural area that is sparsely populated, with an increasingly elderly population, access to a local facility or service is key, and the closure or reduction of services could be disastrous. Scarborough hospital and local hospital trusts are deeply frustrated that there is now a local ward free at Malton hospital, currently unused, which could provide beds for patients entrusted to its care.
	I welcome the Government's policy that decisions should be taken locally, but not before the relevant parties have been adequately consulted. The Minister of State, Department of Health, my hon. Friend the Member for Chelmsford (Mr Burns), wrote to me on 25 August to state that the Government have pledged that, in future,
	"all service changes must be led by clinicians and patients, and are not to be driven from the top down."
	In that letter, he underlined that
	"the Secretary of State for Health has outlined new, strengthened criteria"
	to be followed before fundamental service changes take place, and said that they must
	"focus on improving patient outcomes...consider patient choice...have support from GP commissioners...and...be based on sound clinical evidence."
	In this case, each and every one of those criteria has been flouted, but I understand that Ministers are powerless to act until the end of the pilot scheme. I urge the Secretary of State, the Minister of State and my hon. Friend to look at reviewing this at the earliest opportunity.
	We must ensure that any such fundamental change has the support of all those affected by it. Given that the ward is now closed, it will be harder to reopen it. I cannot see how this is simply a pilot scheme, not a reconfiguration of services. I put it to the House that the decision-making process leading up to the removal of these services was defective and has bypassed those who are most affected by the decisions. Patients must be at the heart of our health care. Local clinicians, doctors, nurses, and patients' loved ones must support the decisions taken.
	Moving forward, where do we want to be at the end of this process? Local people must have confidence in the decision-making process. In the case of the closure of the Ryedale ward, they clearly do not. It is vital that at the end of the so-called pilot scheme, there will be a full, transparent and open consultation. I ask the Minister to outline precisely what form that consultation will take. I urge her to ensure that all those most directly affected will be consulted, including GPs, nurses, Ryedale LINk-local improvement network-Friends of Malton Hospital, and all patients and their loved ones. The primary care trust must desist from the practice of not consulting on any further changes to services. We need to have a proper consultation and better co-ordination of services between the primary care trust and the local hospital trusts.
	I welcome the debate, and I hope that the Minister will reassure me that my long-term ambition for the health service, both locally in North Yorkshire and nationally, will be realised and that clinical need will be at the heart of the delivery of health care.

Anne Milton: I congratulate my hon. Friend the Member for Thirsk and Malton (Miss McIntosh) on securing the debate. I can fully understand her desire to ensure that the best possible health services exist for her constituents, which came across strongly when she metthe Minister of State, Department of Health, my hon. Friend the Member for Chelmsford (Mr Burns), on 12 October to discuss Malton community hospital.
	My hon. Friend is right to say yet again-we say it often, but we cannot say it often enough-that the NHS is a national treasure. It is much loved and much relied upon by all of us, and from my own point of view it was my employer for 25 years. As she rightly stated, patients are at the heart of the service, and need to continue to be. I am sad to say that the story she told this evening is not dissimilar to my experiences in my own constituency, and it shows a big gap: what managers in charge of the finances and commissioners are trying to achieve is very distant from what local people feel.
	I wish to say a little about where we are, because I think I can reassure my hon. Friend that our vision of the health service is well aligned with her own. This Government trust professionals in the NHS, and our White Paper, "Equity and excellence: Liberating the NHS", is about putting that trust into action and sweeping away the old system, which serves only to hamper and curtail the professional judgment of clinicians. We are replacing politically motivated process targets such as how many people are seen and the length of time they wait, which lump all patients together whatever their ailment, and introducing clinical standards generated by the professionals themselves, to hold them to account for the quality of care and outcomes that they provide. My hon. Friend also referred to the vital importance of professionals leading that process.
	The future of local health services will not be dictated from the centre. They will not be directed by strategic health authorities or primary care trusts, they will be designed and commissioned from the bottom up by GPs and their colleagues across the health service, such as clinicians and managers, working in partnership in independent trusts to improve the quality of care. Patients will be armed with unprecedented levels of information and powers of scrutiny, and there will also be input from democratically elected local councillors. That bottom-up approach is important to prevent the present situation from happening again.

Anne McIntosh: What my hon. Friend is saying is music to my ears, but what concerns me is how we have reached a situation in which a major reconfiguration of services has happened without any regard at all to the bottom-up principle.

Anne Milton: I thank my hon. Friend, who is absolutely right. I will come to that.
	As my hon. Friend stated, my right hon. Friend the Secretary of State has identified four crucial tests that all reconfigurations must now pass. First, they must have the support of GP commissioners. Secondly, there must be arrangements for public and patient engagement-no, I would rather say "involvement", because "engagement" is not a favourite word of mine. This is about involvement-people being listened to and their voices being heard, which clearly has not happened in the case that she has described. Thirdly, there must be greater clarity about the clinical evidence base underpinning a proposal. Fourthly, proposals must take into account the need to develop and support patient choice. That is a recipe not for maintaining the status quo but for locally agreed, transparent, evidence-based and clinically led change. Decisions about the services at a local hospital will be driven by local clinicians, with the consent and input of patients and local authorities, not imposed or decided behind closed doors.
	I now turn to Malton community hospital. Providing health services in rural areas can be challenging, and I understand that many patients in north Yorkshire have to travel for as long as 45 minutes to reach their nearest large hospital. Local health services can indeed find it difficult to meet national guidelines, particularly those involving clinical mass. I understand that it is against such a challenging backdrop that North Yorkshire and York PCT is currently considering its strategy for health services in Malton and Ryedale, ensuring that they are safe and sustainable for the future.
	I am happy for my hon. Friend to come back to me on any points that I may raise. I understand that the PCT's emerging strategy for future hospital service provision is based on four themes: prompt local access to assessment and treatment for those needing urgent care; local access to a range of rehabilitation services, delivering intensive rehab and support effectively to re-able patients; prompt and local access to diagnostic tests and, where desirable and feasible, minor surgery; and specialist out-patient services to promote access and to support patient management by local GPs.
	I am also aware of press speculation that Malton community hospital may be closed. The PCT has made it clear that it sees the hospital as an integral part of local health services and that it has no intention of not having a community hospital in Malton. I do not know whether that will reassure my hon. Friend. Judging by the expression on her face, I fear that it may not.
	North Yorkshire and York PCT is currently piloting a scheme of enhanced community service in the Malton and Whitby area. The PCT believes that treating patients closer to home will provide better outcomes and encourage patients to retain their independence. I gather that that pronouncement has been greeted with the same cynicism with which it is greeted in many areas around the country.

Anne McIntosh: No one believes a word that the PCT says any more. There was a cohort of patients-21 at a time-who were treated intensively and given rehabilitation on a ward. They will now not be treated as intensively, and will be less safe when they return home after a fall or a major injury. It is that cohort of patients who will not benefit from hospital at home.

Anne Milton: I understand what my hon. Friend is saying. One of the problems is that we will have to let the pilot run. It is using existing hospital staff to provide hospital care in patients' homes. I gather that there will be no reduction in nursing staff, but delivering care in people's homes is a very different process from delivering it on a hospital ward. Because of financial constraints, it is not possible to run concurrent hospital and community services, so as part of the pilot, the wards have been temporarily closed. I understand that there will be deep cynicism about the prospect of their ever opening again. However, I am assured by the PCT that this is a pilot, and that a full assessment will be made at the end of it.
	The project implementation team meets each week to assess the ongoing impact of the ward closure and bed reductions, and that team includes community provider staff, community hospital matrons and representatives from the community nursing team. I hope that that will continue, and go some way towards reassuring my hon. Friend. The pilot scheme will finish at the end of March 2011, and a full evaluation will take place in April 2011. The PCT has developed criteria for its evaluation-with, I hope, full consultation of local people.
	I reiterate that no final decision has been made about the future of Ryedale ward. If the pilot leads to proposals for permanent service changes, the PCT will need to conduct a full public consultation, underpinned by the principles that I have set out. I hope that the PCT may learn a little from this debate, and from the letters that it has doubtless received, and ensure that local people feel that the consultation is real. I understand that the strategic health authority is working closely with the PCT to ensure that proper process is followed.
	The need to improve clinical outcomes means that local health services will need to evolve, but I hope that, unlike previous changes, any future changes will have the confidence of local communities and clinicians. People must feel that their voice is properly heard; that is what the new arrangements are about. It will not always be easy, but if the process is clear and transparent, and, crucially, if it is led locally by clinicians, it will have the confidence of local people.
	The commitment and tenacity that my hon. Friend shows in fighting for local health services is commendable. I note that she is due to discuss the matter further with the PCT on 19 November. I know that she will continue to work with the local NHS and ensure that her constituents' voices are properly heard and represented, as she always has done.
	The list of enhanced services that my hon. Friend described is particularly significant in the light of the publication of the White Paper. The description of the way in which the ward was closed gives rise to concern and cynicism among local people. It is not useful when organisations act in such a way, because it simply fosters a belief that the PCT is trying to drive something through. We have to let the story run and let the pilot be properly evaluated against the criteria that my right hon. Friend the Secretary of State has outlined.

Anne McIntosh: I am most grateful for my hon. Friend's full reply from the Dispatch Box. On the particular, indeed unique, point that the PCT is both commissioner and provider of the services, will she give me an assurance that the functions will definitely be separated and that such a position will never arise again? It causes undue confusion for all concerned.

Anne Milton: My hon. Friend is right to draw attention to the issues surrounding the commissioning and provision of services. We have grappled with that for some time and we will fully address it. The consultation on the White Paper that we published in July is now finished, and we need to guard against exactly that sort of problem. If there is no Chinese wall or division between commissioning and provision, cynicism and deep suspicion of the commissioning decisions ensue.
	I know that my hon. Friend will continue to make representations and watch the process closely. I assure her that our door will be open to hear any representations that she wants to make.
	 Question put and agreed to.
	 House adjourned.
	Correction
	 Official Report, Monday 15 November 2010: in column 624, at end of second paragraph, "Reptiles ? Us" should read "Reptiles R Us".